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| 3 | + | LCO \\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-07303-R01- | |
| 4 | + | HB.docx | |
| 5 | + | 1 of 19 | |
| 6 | + | ||
| 7 | + | General Assembly Substitute Bill No. 7303 | |
| 8 | + | January Session, 2019 | |
| 1 | 9 | ||
| 2 | 10 | ||
| 3 | 11 | ||
| 4 | - | Substitute House Bill No. 7303 | |
| 5 | - | ||
| 6 | - | Public Act No. 19-72 | |
| 7 | 12 | ||
| 8 | 13 | ||
| 9 | 14 | AN ACT CONCERNING DE NTAL PRACTITIONERS. | |
| 10 | 15 | Be it enacted by the Senate and House of Representatives in General | |
| 11 | 16 | Assembly convened: | |
| 12 | 17 | ||
| 13 | - | Section 1. Section 20-107 of the general statutes is repealed and the | |
| 14 | - | following is substituted in lieu thereof (Effective January 1, 2020): | |
| 15 | - | (a) Each application for a license to practice dentistry shall be [in | |
| 16 | - | writing and signed by] submitted by the applicant and no license shall | |
| 17 | - | be issued to any person unless he or she presents (1) a diploma or | |
| 18 | - | other certificate of graduation conferring a dental degree from [some | |
| 19 | - | reputable] a dental college or from a department of dentistry of a | |
| 20 | - | medical college [conferring a dental degree, or unless he or she is | |
| 21 | - | practicing as a legally qualified dentist in another state having | |
| 22 | - | requirements for admission determined by the department to be | |
| 23 | - | similar to or higher than the requirements of this state] accredited by | |
| 24 | - | the American Dental Association's Commission on Dental | |
| 25 | - | Accreditation or its successor organization; (2) evidence of satisfactory | |
| 26 | - | completion of a written examination or examinations given by the | |
| 27 | - | Joint Commission on National Dental Examinations, subject to such | |
| 28 | - | conditions as the State Dental Commission as described in section 20- | |
| 29 | - | 103a, with the consent of the Commissioner of Public Health, may | |
| 30 | - | prescribe; and (3) evidence of satisfactory completion of at least one | |
| 31 | - | year of a clinically based postdoctoral general practice or specialty Substitute House Bill No. 7303 | |
| 18 | + | Section 1. Section 20-107 of the general statutes is repealed and the 1 | |
| 19 | + | following is substituted in lieu thereof (Effective January 1, 2020): 2 | |
| 20 | + | (a) Each application for a license to practice dentistry shall be [in 3 | |
| 21 | + | writing and signed by] submitted by the applicant and no license shall 4 | |
| 22 | + | be issued to any person unless he or she presents (1) a diploma or 5 | |
| 23 | + | other certificate of graduation conferring a dental degree from [some 6 | |
| 24 | + | reputable] a dental college or from a department of dentistry of a 7 | |
| 25 | + | medical college [conferring a dental degree, or unless he or she is 8 | |
| 26 | + | practicing as a legally qualified dentist in another state having 9 | |
| 27 | + | requirements for admission determined by the department to be 10 | |
| 28 | + | similar to or higher than the requirements of this state] accredited by 11 | |
| 29 | + | the American Dental Association's Commission on Dental 12 | |
| 30 | + | Accreditation or its successor organization; (2) evidence of satisfactory 13 | |
| 31 | + | completion of a written examination or examinations given by the 14 | |
| 32 | + | Joint Commission on National Dental Examinations, subject to such 15 | |
| 33 | + | conditions as the State Dental Commission as described in section 20-16 | |
| 34 | + | 103a, with the consent of the Commissioner of Public Health, may 17 | |
| 35 | + | prescribe; and (3) evidence of satisfactory completion of at least one 18 | |
| 36 | + | year of a clinically based postdoctoral general practice or specialty 19 | |
| 37 | + | dental residency program accredited by the Commission on Dental 20 Substitute Bill No. 7303 | |
| 32 | 38 | ||
| 33 | - | Public Act No. 19-72 2 of 12 | |
| 34 | 39 | ||
| 35 | - | dental residency program accredited by the Commission on Dental | |
| 36 | - | Accreditation, or its successor organization. | |
| 37 | - | [(b) The Dental Commission may, with the consent of the | |
| 38 | - | Commissioner of Public Health, determine the colleges which shall be | |
| 39 | - | considered reputable dental or medical colleges for the purposes of | |
| 40 | - | this chapter. The commission shall consult when possible with | |
| 41 | - | nationally recognized accrediting agencies when making such | |
| 42 | - | determinations.] | |
| 43 | - | [(c)] (b) Notwithstanding the provisions of [subsections] subsection | |
| 44 | - | (a) [and (b)] of this section, the department may issue a license to | |
| 45 | - | practice dentistry to any applicant holding a diploma from a foreign | |
| 46 | - | dental school, provided the applicant: (1) [is] Is a graduate of a dental | |
| 47 | - | school located outside the United States and has received the degree of | |
| 48 | - | doctor of dental medicine or surgery, or its equivalent; (2) [has] passed | |
| 49 | - | the written and practical examination or examinations required in | |
| 50 | - | subsection (a) of this section or section 20-108, as amended by this act; | |
| 51 | - | (3) [has] successfully completed not less than two years of graduate | |
| 52 | - | dental training as a resident dentist in a program accredited by the | |
| 53 | - | Commission on Dental Accreditation; and (4) [has] successfully | |
| 54 | - | completed, at a level greater than the second postgraduate year, not | |
| 55 | - | less than three years of a residency or fellowship training program | |
| 56 | - | accredited by the Commission on Dental Accreditation in a school of | |
| 57 | - | dentistry in this state, or has served as a full-time faculty member of a | |
| 58 | - | school of dentistry in this state pursuant to the provisions of section | |
| 59 | - | 20-120 for not less than three years. | |
| 60 | - | Sec. 2. Section 20-108 of the general statutes is repealed and the | |
| 61 | - | following is substituted in lieu thereof (Effective January 1, 2020): | |
| 62 | - | [(a) Except as provided in section 20-110 and subsection (b) of this | |
| 63 | - | section, each applicant for a license to practice dental medicine or | |
| 64 | - | dental surgery shall be examined by the Department of Public Health, Substitute House Bill No. 7303 | |
| 40 | + | LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-07303- | |
| 41 | + | R01-HB.docx } | |
| 42 | + | 2 of 19 | |
| 65 | 43 | ||
| 66 | - | Public Act No. 19-72 3 of 12 | |
| 44 | + | Accreditation, or its successor organization. 21 | |
| 45 | + | [(b) The Dental Commission may, with the consent of the 22 | |
| 46 | + | Commissioner of Public Health, determine the colleges which shall be 23 | |
| 47 | + | considered reputable dental or medical colleges for the purposes of 24 | |
| 48 | + | this chapter. The commission shall consult when possible with 25 | |
| 49 | + | nationally recognized accrediting agencies when making such 26 | |
| 50 | + | determinations.] 27 | |
| 51 | + | [(c)] (b) Notwithstanding the provisions of [subsections] subsection 28 | |
| 52 | + | (a) [and (b)] of this section, the department may issue a license to 29 | |
| 53 | + | practice dentistry to any applicant holding a diploma from a foreign 30 | |
| 54 | + | dental school, provided the applicant: (1) [is] Is a graduate of a dental 31 | |
| 55 | + | school located outside the United States and has received the degree of 32 | |
| 56 | + | doctor of dental medicine or surgery, or its equivalent; (2) [has] passed 33 | |
| 57 | + | the written and practical examination or examinations required in 34 | |
| 58 | + | subsection (a) of this section or section 20-108, as amended by this act; 35 | |
| 59 | + | (3) [has] successfully completed not less than two years of graduate 36 | |
| 60 | + | dental training as a resident dentist in a program accredited by the 37 | |
| 61 | + | Commission on Dental Accreditation; and (4) [has] successfully 38 | |
| 62 | + | completed, at a level greater than the second postgraduate year, not 39 | |
| 63 | + | less than three years of a residency or fellowship training program 40 | |
| 64 | + | accredited by the Commission on Dental Accreditation in a school of 41 | |
| 65 | + | dentistry in this state, or has served as a full-time faculty member of a 42 | |
| 66 | + | school of dentistry in this state pursuant to the provisions of section 43 | |
| 67 | + | 20-120 for not less than three years. 44 | |
| 68 | + | Sec. 2. Section 20-108 of the general statutes is repealed and the 45 | |
| 69 | + | following is substituted in lieu thereof (Effective January 1, 2020): 46 | |
| 70 | + | [(a) Except as provided in section 20-110 and subsection (b) of this 47 | |
| 71 | + | section, each applicant for a license to practice dental medicine or 48 | |
| 72 | + | dental surgery shall be examined by the Department of Public Health, 49 | |
| 73 | + | under the supervision of the Dental Commission as to his or her 50 | |
| 74 | + | professional knowledge and skill before such license is granted. Such 51 | |
| 75 | + | examination shall be conducted in the English language.] The State 52 Substitute Bill No. 7303 | |
| 67 | 76 | ||
| 68 | - | under the supervision of the Dental Commission as to his or her | |
| 69 | - | professional knowledge and skill before such license is granted. Such | |
| 70 | - | examination shall be conducted in the English language.] The State | |
| 71 | - | Dental Commission may, with the consent of the Commissioner of | |
| 72 | - | Public Health, accept and approve [, in lieu of the written examination | |
| 73 | - | required by this section, the results of an examination given by the | |
| 74 | - | Joint Commission on National Dental Examinations, subject to such | |
| 75 | - | conditions as the commission may prescribe, and the Dental | |
| 76 | - | Commission with the consent of the Commissioner of Public Health, | |
| 77 | - | may accept and approve, in lieu of the written and practical | |
| 78 | - | examination required by this section,] the results of [regional testing | |
| 79 | - | agencies as to written and] clinical or practical examinations, subject to | |
| 80 | - | such conditions as [the] said commission, with the consent of the | |
| 81 | - | Commissioner of Public Health, may prescribe in lieu of the clinically | |
| 82 | - | based postdoctoral general practice or specialty dental residency | |
| 83 | - | program required pursuant to subsection (a) of section 20-107, as | |
| 84 | - | amended by this act. On and after July 1, 2021, or upon the State | |
| 85 | - | Dental Commission's approval of examinations that do not require the | |
| 86 | - | participation of patients, whichever is earlier, such clinical or practical | |
| 87 | - | examinations shall not require the participation of patients. Passing | |
| 88 | - | scores shall be established by the department with the consent of the | |
| 89 | - | commission. | |
| 90 | - | [(b) In lieu of the practical examination required by subsection (a) of | |
| 91 | - | this section, an applicant for licensure may submit evidence of having | |
| 92 | - | successfully completed not less than one year of graduate dental | |
| 93 | - | training as a resident dentist in a program accredited by the | |
| 94 | - | Commission on Dental Accreditation, provided the director of the | |
| 95 | - | dental residency program at the facility in which the applicant | |
| 96 | - | completed the residency training provides documentation satisfactory | |
| 97 | - | to the Department of Public Health attesting to the resident dentist's | |
| 98 | - | competency in all areas tested on the practical examination required by | |
| 99 | - | subsection (a) of this section. Not later than December 1, 2005, the Substitute House Bill No. 7303 | |
| 100 | 77 | ||
| 101 | - | Public Act No. 19-72 4 of 12 | |
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| 102 | 81 | ||
| 103 | - | Dental Commission, in consultation with the Department of Public | |
| 104 | - | Health, shall develop a form upon which such documentation shall be | |
| 105 | - | provided.] | |
| 106 | - | Sec. 3. Section 20-110 of the general statutes is repealed and the | |
| 107 | - | following is substituted in lieu thereof (Effective January 1, 2020): | |
| 108 | - | The Department of Public Health may, upon receipt of an | |
| 109 | - | application and a fee of five hundred sixty-five dollars, issue a license | |
| 110 | - | without examination to a practicing dentist in another state or territory | |
| 111 | - | who (1) holds a current valid license in good professional standing | |
| 112 | - | issued after examination by another state or territory that maintains | |
| 113 | - | licensing standards which, except for the practical examination, are | |
| 114 | - | commensurate with the state's standards, and (2) has worked | |
| 115 | - | continuously as a licensed dentist in an academic or clinical setting in | |
| 116 | - | another state or territory for a period of not less than [five years] one | |
| 117 | - | year immediately preceding the application for licensure without | |
| 118 | - | examination. No license shall be issued under this section to any | |
| 119 | - | applicant against whom professional disciplinary action is pending or | |
| 120 | - | who is the subject of an unresolved complaint. The department shall | |
| 121 | - | inform the Dental Commission annually of the number of applications | |
| 122 | - | it receives for licensure under this section. | |
| 123 | - | Sec. 4. Subsection (a) of section 20-126o of the general statutes is | |
| 124 | - | repealed and the following is substituted in lieu thereof (Effective | |
| 125 | - | January 1, 2020): | |
| 126 | - | (a) The Department of Public Health may take any of the actions set | |
| 127 | - | forth in section 19a-17 for any of the following causes: (1) The | |
| 128 | - | presentation to the department of any diploma, license or certificate | |
| 129 | - | illegally or fraudulently obtained, or obtained from an institution that | |
| 130 | - | is not accredited or from an unrecognized or irregular institution or | |
| 131 | - | state board, or obtained by the practice of any fraud or deception; (2) | |
| 132 | - | illegal conduct; (3) negligent, incompetent or wrongful conduct in Substitute House Bill No. 7303 | |
| 82 | + | Dental Commission may, with the consent of the Commissioner of 53 | |
| 83 | + | Public Health, accept and approve [, in lieu of the written examination 54 | |
| 84 | + | required by this section, the results of an examination given by the 55 | |
| 85 | + | Joint Commission on National Dental Examinations, subject to such 56 | |
| 86 | + | conditions as the commission may prescribe, and the Dental 57 | |
| 87 | + | Commission with the consent of the Commissioner of Public Health, 58 | |
| 88 | + | may accept and approve, in lieu of the written and practical 59 | |
| 89 | + | examination required by this section,] the results of [regional testing 60 | |
| 90 | + | agencies as to written and] clinical or practical examinations, subject to 61 | |
| 91 | + | such conditions as [the] said commission, with the consent of the 62 | |
| 92 | + | Commissioner of Public Health, may prescribe in lieu of the clinically 63 | |
| 93 | + | based postdoctoral general practice or specialty dental residency 64 | |
| 94 | + | program required pursuant to subsection (a) of section 20-107, as 65 | |
| 95 | + | amended by this act. On and after July 1, 2021, or upon the State 66 | |
| 96 | + | Dental Commission's approval of examinations that do not require the 67 | |
| 97 | + | participation of patients, whichever is earlier, such clinical or practical 68 | |
| 98 | + | examinations shall not require the participation of patients. Passing 69 | |
| 99 | + | scores shall be established by the department with the consent of the 70 | |
| 100 | + | commission. 71 | |
| 101 | + | [(b) In lieu of the practical examination required by subsection (a) of 72 | |
| 102 | + | this section, an applicant for licensure may submit evidence of having 73 | |
| 103 | + | successfully completed not less than one year of graduate dental 74 | |
| 104 | + | training as a resident dentist in a program accredited by the 75 | |
| 105 | + | Commission on Dental Accreditation, provided the director of the 76 | |
| 106 | + | dental residency program at the facility in which the applicant 77 | |
| 107 | + | completed the residency training provides documentation satisfactory 78 | |
| 108 | + | to the Department of Public Health attesting to the resident dentist's 79 | |
| 109 | + | competency in all areas tested on the practical examination required by 80 | |
| 110 | + | subsection (a) of this section. Not later than December 1, 2005, the 81 | |
| 111 | + | Dental Commission, in consultation with the Department of Public 82 | |
| 112 | + | Health, shall develop a form upon which such documentation shall be 83 | |
| 113 | + | provided.] 84 | |
| 114 | + | Sec. 3. Section 20-110 of the general statutes is repealed and the 85 Substitute Bill No. 7303 | |
| 133 | 115 | ||
| 134 | - | Public Act No. 19-72 5 of 12 | |
| 135 | 116 | ||
| 136 | - | professional activities; (4) conviction of the violation of any of the | |
| 137 | - | provisions of sections 20-126h to 20-126w, inclusive, or section 14 of | |
| 138 | - | public act 19-56 by any court of criminal jurisdiction; (5) the violation | |
| 139 | - | of any of the provisions of said sections or of the regulations adopted | |
| 140 | - | hereunder or the refusal to comply with any of said provisions or | |
| 141 | - | regulations; (6) the aiding or abetting in the practice of dental hygiene | |
| 142 | - | of a person not licensed to practice dental hygiene in this state; (7) | |
| 143 | - | engaging in fraud or material deception in the course of professional | |
| 144 | - | activities; (8) the effects of physical or mental illness, emotional | |
| 145 | - | disorder or loss of motor skill, including, but not limited to, | |
| 146 | - | deterioration through the aging process, upon the license holder; (9) | |
| 147 | - | abuse or excessive use of drugs, including alcohol, narcotics or | |
| 148 | - | chemicals; or (10) failure to provide information to the Department of | |
| 149 | - | Public Health required to complete a health care provider profile, as | |
| 150 | - | set forth in section 20-13j. A violation of any of the provisions of | |
| 151 | - | sections 20-126h to 20-126w, inclusive, or section 14 of public act 19-56 | |
| 152 | - | by any unlicensed employee in the practice of dental hygiene, with the | |
| 153 | - | knowledge of his or her employer, shall be deemed a violation thereof | |
| 154 | - | by his or her employer. The Commissioner of Public Health may order | |
| 155 | - | a license holder to submit to a reasonable physical or mental | |
| 156 | - | examination if his or her physical or mental capacity to practice safely | |
| 157 | - | is the subject of an investigation. Said commissioner may petition the | |
| 158 | - | superior court for the judicial district of Hartford to enforce such order | |
| 159 | - | or any action taken pursuant to said section 19a-17. | |
| 160 | - | Sec. 5. Section 20-126t of the general statutes is repealed and the | |
| 161 | - | following is substituted in lieu thereof (Effective January 1, 2020): | |
| 162 | - | Any person who violates any provision of sections 20-126h to 20- | |
| 163 | - | 126w, inclusive, or section 14 of public act 19-56 shall be guilty of a | |
| 164 | - | class D felony. Any person who continues to practice dental hygiene or | |
| 165 | - | engage as a dental hygienist, after his license or authority to so do has | |
| 166 | - | been suspended or revoked and while such disability continues, shall Substitute House Bill No. 7303 | |
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| 167 | 120 | ||
| 168 | - | Public Act No. 19-72 6 of 12 | |
| 121 | + | following is substituted in lieu thereof (Effective January 1, 2020): 86 | |
| 122 | + | The Department of Public Health may, upon receipt of an 87 | |
| 123 | + | application and a fee of five hundred sixty-five dollars, issue a license 88 | |
| 124 | + | without examination to a practicing dentist in another state or territory 89 | |
| 125 | + | who (1) holds a current valid license in good professional standing 90 | |
| 126 | + | issued after examination by another state or territory that maintains 91 | |
| 127 | + | licensing standards which, except for the practical examination, are 92 | |
| 128 | + | commensurate with the state's standards, and (2) has worked 93 | |
| 129 | + | continuously as a licensed dentist in an academic or clinical setting in 94 | |
| 130 | + | another state or territory for a period of not less than [five years] one 95 | |
| 131 | + | year immediately preceding the application for licensure without 96 | |
| 132 | + | examination. No license shall be issued under this section to any 97 | |
| 133 | + | applicant against whom professional disciplinary action is pending or 98 | |
| 134 | + | who is the subject of an unresolved complaint. The department shall 99 | |
| 135 | + | inform the Dental Commission annually of the number of applications 100 | |
| 136 | + | it receives for licensure under this section. 101 | |
| 137 | + | Sec. 4. (NEW) (Effective January 1, 2020) (a) As used in this section: 102 | |
| 138 | + | (1) "Practice of advanced dental therapy" means the performance of 103 | |
| 139 | + | educational, preventive and therapeutic services through any one or 104 | |
| 140 | + | more of the following practices and procedures: (A) Identification of 105 | |
| 141 | + | oral and systemic conditions requiring evaluation or treatment by 106 | |
| 142 | + | dentists, physicians or other health care providers, and management of 107 | |
| 143 | + | referrals to dentists, physicians and other health care providers; (B) 108 | |
| 144 | + | diagnosis and treatment of oral diseases and conditions that are within 109 | |
| 145 | + | the advanced practice dental therapist scope of practice; (C) 110 | |
| 146 | + | comprehensive charting of the oral cavity; (D) oral health instruction 111 | |
| 147 | + | and disease prevention education, including nutritional counseling 112 | |
| 148 | + | and dietary analysis; (E) dispensing and administering of nonnarcotic 113 | |
| 149 | + | analgesics and anti-inflammatory and antibiotic medications as 114 | |
| 150 | + | prescribed by a licensed health care provider, except schedule II, III or 115 | |
| 151 | + | IV controlled substances; (F) applying topical preventive or 116 | |
| 152 | + | prophylactic agents, including fluoride varnish, antimicrobial agents 117 | |
| 153 | + | and pit and fissure sealants; (G) pulp vitality testing; (H) applying 118 Substitute Bill No. 7303 | |
| 169 | 154 | ||
| 170 | - | be guilty of a class D felony. For the purposes of this section, each | |
| 171 | - | instance of patient contact or consultation which is in violation of any | |
| 172 | - | provision of this section shall constitute a separate offense. Failure to | |
| 173 | - | renew a license in a timely manner shall not constitute a violation for | |
| 174 | - | the purposes of this section. | |
| 175 | - | Sec. 6. Subsections (a) and (b) of section 20-126c of the general | |
| 176 | - | statutes are repealed and the following is substituted in lieu thereof | |
| 177 | - | (Effective January 1, 2020): | |
| 178 | - | (a) As used in this section: | |
| 179 | - | (1) "Commissioner" means the Commissioner of Public Health; | |
| 180 | - | (2) "Contact hour" means a minimum of fifty minutes of continuing | |
| 181 | - | education activity; | |
| 182 | - | (3) "Department" means the Department of Public Health; | |
| 183 | - | (4) "Licensee" means any person who receives a license from the | |
| 184 | - | department pursuant to this chapter; [and] | |
| 185 | - | (5) "Registration period" means the one-year period for which a | |
| 186 | - | license renewed in accordance with section 19a-88 is current and valid; | |
| 187 | - | [.] and | |
| 188 | - | (6) "Temporary dental clinic" means a dental clinic that provides | |
| 189 | - | dental care services at no cost to uninsured or underinsured persons | |
| 190 | - | and operates for not more than seventy-two consecutive hours. | |
| 191 | - | (b) Except as otherwise provided in this section, a licensee applying | |
| 192 | - | for license renewal shall earn a minimum of twenty-five contact hours | |
| 193 | - | of continuing education within the preceding twenty-four-month | |
| 194 | - | period. Such continuing education shall (1) be in an area of the | |
| 195 | - | licensee's practice; (2) reflect the professional needs of the licensee in | |
| 196 | - | order to meet the health care needs of the public; and (3) include not Substitute House Bill No. 7303 | |
| 197 | 155 | ||
| 198 | - | Public Act No. 19-72 7 of 12 | |
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| 199 | 159 | ||
| 200 | - | less than one contact hour of training or education in (A) any three of | |
| 201 | - | the ten mandatory topics for continuing education activities prescribed | |
| 202 | - | by the commissioner pursuant to this subdivision, (B) for registration | |
| 203 | - | periods beginning on and after October 1, 2016, infection control in a | |
| 204 | - | dental setting, and (C) prescribing controlled substances and pain | |
| 205 | - | management. For registration periods beginning on and after October | |
| 206 | - | 1, 2011, the Commissioner of Public Health, in consultation with the | |
| 207 | - | Dental Commission, shall on or before October 1, 2010, and biennially | |
| 208 | - | thereafter, issue a list that includes ten mandatory topics for | |
| 209 | - | continuing education activities that will be required for the following | |
| 210 | - | two-year registration period. Qualifying continuing education | |
| 211 | - | activities include, but are not limited to, courses, including on-line | |
| 212 | - | courses, offered or approved by the American Dental Association or | |
| 213 | - | state, district or local dental associations and societies affiliated with | |
| 214 | - | the American Dental Association; national, state, district or local dental | |
| 215 | - | specialty organizations or the American Academy of General | |
| 216 | - | Dentistry; a hospital or other health care institution; dental schools and | |
| 217 | - | other schools of higher education accredited or recognized by the | |
| 218 | - | Council on Dental Accreditation or a regional accrediting organization; | |
| 219 | - | agencies or businesses whose programs are accredited or recognized | |
| 220 | - | by the Council on Dental Accreditation; local, state or national medical | |
| 221 | - | associations; a state or local health department; or the Accreditation | |
| 222 | - | Council for Graduate Medical Education. Eight hours of volunteer | |
| 223 | - | dental practice at a public health facility, as defined in section 20-126l, | |
| 224 | - | as amended by this act, or a temporary dental clinic may be | |
| 225 | - | substituted for one contact hour of continuing education, up to a | |
| 226 | - | maximum of ten contact hours in one twenty-four-month period. | |
| 227 | - | Sec. 7. Subsection (a) of section 20-126l of the general statutes is | |
| 228 | - | repealed and the following is substituted in lieu thereof (Effective | |
| 229 | - | January 1, 2020): | |
| 230 | - | (a) As used in this section: Substitute House Bill No. 7303 | |
| 160 | + | desensitizing medication or resin in the oral cavity; (I) interim 119 | |
| 161 | + | therapeutic restorations; (J) fabricating athletic mouth guards; (K) 120 | |
| 162 | + | changing periodontal dressings; (L) administering local anesthetics in 121 | |
| 163 | + | the oral cavity under the general supervision of a dentist; (M) simple 122 | |
| 164 | + | extraction of erupted primary teeth; (N) nonsurgical extraction of 123 | |
| 165 | + | periodontally diseased permanent teeth with tooth mobility of three or 124 | |
| 166 | + | greater, except a tooth that is unerupted, impacted, fractured or needs 125 | |
| 167 | + | to be sectioned for removal; (O) emergency palliative treatment of 126 | |
| 168 | + | dental pain; (P) preparation and placement of direct restoration in 127 | |
| 169 | + | primary and permanent teeth that does not require the fabrication of 128 | |
| 170 | + | crowns, bridges, veneers or dentures; (Q) fabrication and placement of 129 | |
| 171 | + | single-tooth temporary crowns; (R) preparation and placement of 130 | |
| 172 | + | preformed crowns on primary teeth; (S) indirect and direct pulp 131 | |
| 173 | + | capping on permanent teeth; (T) indirect pulp capping on primary 132 | |
| 174 | + | teeth; (U) dental suture removal; (V) minor adjustments and repairs on 133 | |
| 175 | + | removable prostheses; (W) placement and removal of space 134 | |
| 176 | + | maintainers; and (X) recementing permanent crowns; 135 | |
| 177 | + | (2) "Collaborative agreement" means a written agreement between 136 | |
| 178 | + | an advanced practice dental therapist and a dentist licensed pursuant 137 | |
| 179 | + | to chapter 379 of the general statutes, that defines the working 138 | |
| 180 | + | relationship between the advanced practice dental therapist and the 139 | |
| 181 | + | dentist and the parameters of the practice provided by such advanced 140 | |
| 182 | + | practice dental therapist in accordance with subdivision (1) of this 141 | |
| 183 | + | subsection; 142 | |
| 184 | + | (3) "Advanced practice dental therapist" means a person authorized 143 | |
| 185 | + | to engage in the practice of advanced practice dental therapy under a 144 | |
| 186 | + | collaborative agreement; and 145 | |
| 187 | + | (4) "Public health facility" has the same meaning as provided in 146 | |
| 188 | + | section 20-126l of the general statutes, as amended by this act. 147 | |
| 189 | + | (b) No person shall engage in the advanced practice of dental 148 | |
| 190 | + | therapy unless such person (1) is a dental hygienist licensed pursuant 149 | |
| 191 | + | to chapter 379a of the general statutes; (2) has obtained an advanced 150 Substitute Bill No. 7303 | |
| 231 | 192 | ||
| 232 | - | Public Act No. 19-72 8 of 12 | |
| 233 | 193 | ||
| 234 | - | (1) "General supervision of a licensed dentist" means supervision | |
| 235 | - | that authorizes dental hygiene procedures to be performed with the | |
| 236 | - | knowledge of said licensed dentist, whether or not the dentist is on the | |
| 237 | - | premises when such procedures are being performed; | |
| 238 | - | (2) "Public health facility" means an institution, as defined in section | |
| 239 | - | 19a-490, a community health center, a group home, a school, a | |
| 240 | - | preschool operated by a local or regional board of education, a head | |
| 241 | - | start program or a program offered or sponsored by the federal Special | |
| 242 | - | Supplemental Food Program for Women, Infants and Children, a | |
| 243 | - | senior center or a managed residential community, as defined in | |
| 244 | - | section 19a-693, [or] a licensed child care center, as described in section | |
| 245 | - | 19a-77, or a temporary dental clinic, as defined in section 20-126c, as | |
| 246 | - | amended by this act; | |
| 247 | - | (3) The "practice of dental hygiene" means the performance of | |
| 248 | - | educational, preventive and therapeutic services including: Complete | |
| 249 | - | prophylaxis; the removal of [calcerous] calcareous deposits, accretions | |
| 250 | - | and stains from the supragingival and subgingival surfaces of the teeth | |
| 251 | - | by scaling, root planing and polishing; the application of pit and | |
| 252 | - | fissure sealants and topical solutions to exposed portions of the teeth; | |
| 253 | - | dental hygiene examinations and the charting of oral conditions; | |
| 254 | - | dental hygiene assessment, treatment planning and evaluation; the | |
| 255 | - | administration of local anesthesia in accordance with the provisions of | |
| 256 | - | subsection (d) of this section; taking alginate impressions of teeth, | |
| 257 | - | under the indirect supervision of a dentist, for use in study models, | |
| 258 | - | orthodontic appliances, whitening trays, mouth guards and fabrication | |
| 259 | - | of temporary crowns; and collaboration in the implementation of the | |
| 260 | - | oral health care regimen; and | |
| 261 | - | (4) "Contact hour" means a minimum of fifty minutes of continuing | |
| 262 | - | education activity. | |
| 263 | - | Sec. 8. Subsection (g) of section 20-126l of the general statutes is Substitute House Bill No. 7303 | |
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| 264 | 197 | ||
| 265 | - | Public Act No. 19-72 9 of 12 | |
| 198 | + | practice dental therapist certification that is (A) in writing, on a form 151 | |
| 199 | + | issued by an institution of higher education accredited by the 152 | |
| 200 | + | Commission on Dental Accreditation after successful completion of an 153 | |
| 201 | + | advanced dental therapy program that includes, in accordance with 154 | |
| 202 | + | the Commission on Dental Accreditation's accreditation standards for 155 | |
| 203 | + | dental therapy education programs, full-time instruction or its 156 | |
| 204 | + | equivalent at the postsecondary college level and incorporates all 157 | |
| 205 | + | advanced dental therapy practice competencies, (B) signed by the 158 | |
| 206 | + | advanced practice dental therapist and the director of the dental 159 | |
| 207 | + | therapy education program, and (C) made available to the Department 160 | |
| 208 | + | of Public Health upon request; (3) has successfully completed a 161 | |
| 209 | + | comprehensive examination prescribed by the Commission on Dental 162 | |
| 210 | + | Competency Assessments, or its equivalent, and administered 163 | |
| 211 | + | independently of any institution of higher education that offers a 164 | |
| 212 | + | program in advanced practice dental therapy; (4) prior to entering the 165 | |
| 213 | + | first collaborative agreement, (A) has received a certificate of 166 | |
| 214 | + | completion, signed by a dentist licensed pursuant to chapter 379 of the 167 | |
| 215 | + | general statutes, that verifies completion of one thousand hours of 168 | |
| 216 | + | clinical training under the direct supervision of such dentist, and (B) 169 | |
| 217 | + | has successfully completed six hours of continuing education related 170 | |
| 218 | + | to dental therapy; and (5) has entered into a collaborative agreement 171 | |
| 219 | + | with a dentist. 172 | |
| 220 | + | (c) An advanced practice dental therapist shall practice in a public 173 | |
| 221 | + | health facility under the general supervision of a dentist licensed 174 | |
| 222 | + | pursuant to chapter 379 of the general statutes in accordance with a 175 | |
| 223 | + | collaborative agreement. 176 | |
| 224 | + | (d) No provision of this section shall be construed to prohibit a 177 | |
| 225 | + | dental hygienist enrolled in an advanced practice dental therapy 178 | |
| 226 | + | program, as described in subdivision (2) of subsection (b) of this 179 | |
| 227 | + | section, from performing dental therapy work as a required 180 | |
| 228 | + | component of his or her course of study in such program, provided 181 | |
| 229 | + | such dental hygienist (1) performs such work under the direct 182 | |
| 230 | + | supervision of a dentist licensed pursuant to chapter 379 of the general 183 Substitute Bill No. 7303 | |
| 266 | 231 | ||
| 267 | - | repealed and the following is substituted in lieu thereof (Effective | |
| 268 | - | January 1, 2020): | |
| 269 | - | (g) Each licensed dental hygienist applying for license renewal shall | |
| 270 | - | earn a minimum of sixteen contact hours of continuing education | |
| 271 | - | within the preceding twenty-four-month period, including, for | |
| 272 | - | registration periods beginning on and after October 1, 2016, at least | |
| 273 | - | one contact hour of training or education in infection control in a | |
| 274 | - | dental setting and, for registration periods beginning on and after | |
| 275 | - | October 1, 2017, at least one contact hour of training or education in | |
| 276 | - | cultural competency. The subject matter for continuing education shall | |
| 277 | - | reflect the professional needs of the licensee in order to meet the health | |
| 278 | - | care needs of the public. Continuing education activities shall provide | |
| 279 | - | significant theoretical or practical content directly related to clinical or | |
| 280 | - | scientific aspects of dental hygiene. Qualifying continuing education | |
| 281 | - | activities include, but are not limited to, courses, including on-line | |
| 282 | - | courses, that are offered or approved by dental schools and other | |
| 283 | - | institutions of higher education that are accredited or recognized by | |
| 284 | - | the Council on Dental Accreditation, a regional accrediting | |
| 285 | - | organization, the American Dental Association, a state, district or local | |
| 286 | - | dental association or society affiliated with the American Dental | |
| 287 | - | Association, the National Dental Association, the American Dental | |
| 288 | - | Hygienists Association or a state, district or local dental hygiene | |
| 289 | - | association or society affiliated with the American Dental Hygienists | |
| 290 | - | Association, the Academy of General Dentistry, the Academy of | |
| 291 | - | Dental Hygiene, the American Red Cross or the American Heart | |
| 292 | - | Association when sponsoring programs in cardiopulmonary | |
| 293 | - | resuscitation or cardiac life support, the United States Department of | |
| 294 | - | Veterans Affairs and armed forces of the United States when | |
| 295 | - | conducting programs at United States governmental facilities, a | |
| 296 | - | hospital or other health care institution, agencies or businesses whose | |
| 297 | - | programs are accredited or recognized by the Council on Dental | |
| 298 | - | Accreditation, local, state or national medical associations, or a state or Substitute House Bill No. 7303 | |
| 299 | 232 | ||
| 300 | - | Public Act No. 19-72 10 of 12 | |
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| 301 | 236 | ||
| 302 | - | local health department. Eight hours of volunteer dental practice at a | |
| 303 | - | public health facility, as defined in subsection (a) of this section, may | |
| 304 | - | be substituted for one contact hour of continuing education, up to a | |
| 305 | - | maximum of five contact hours in one two-year period. Activities that | |
| 306 | - | do not qualify toward meeting these requirements include professional | |
| 307 | - | organizational business meetings, speeches delivered at luncheons or | |
| 308 | - | banquets, and the reading of books, articles, or professional journals. | |
| 309 | - | [Not more than four contact hours of continuing education may be | |
| 310 | - | earned through an on-line or other distance learning program.] | |
| 311 | - | Sec. 9. Section 20-126l of the general statutes is amended by adding | |
| 312 | - | subsection (l) as follows (Effective January 1, 2020): | |
| 313 | - | (NEW) (l) No provision of chapter 379a shall be construed to | |
| 314 | - | prohibit a student of dental hygiene enrolled in a dental hygiene | |
| 315 | - | program, as described in section 20-126i, from performing dental | |
| 316 | - | hygiene work as a required component of his or her course of study in | |
| 317 | - | such program, provided the student (1) performs such work under the | |
| 318 | - | direct supervision of a dentist licensed pursuant to chapter 379 or a | |
| 319 | - | dental hygienist licensed pursuant to chapter 379a, (2) shall not hold | |
| 320 | - | himself or herself out as a licensed dental hygienist, and (3) shall not | |
| 321 | - | receive compensation for such work. | |
| 322 | - | Sec. 10. (Effective July 1, 2019) The chairpersons of the joint standing | |
| 323 | - | committee of the General Assembly having cognizance of matters | |
| 324 | - | relating to public health shall convene a working group to advise said | |
| 325 | - | joint standing committee regarding the licensure of dental therapists | |
| 326 | - | by the Department of Public Health. The working group shall be | |
| 327 | - | comprised of (1) the chairpersons of such joint standing committee, or | |
| 328 | - | the chairpersons' designees, (2) the Commissioner of Public Health, or | |
| 329 | - | the commissioner's designee, (3) representatives of the Connecticut | |
| 330 | - | State Dental Association, including, at least one dentist and one dental | |
| 331 | - | hygienist, (4) a dental therapist certified in another state, (5) the | |
| 332 | - | president of the Board of Regents for Higher Education, or the Substitute House Bill No. 7303 | |
| 237 | + | statutes, (2) shall not hold himself or herself out as a certified advanced 184 | |
| 238 | + | practice dental therapist, and (3) shall not receive compensation for 185 | |
| 239 | + | such work. 186 | |
| 240 | + | (e) (1) A collaborative agreement entered into pursuant to 187 | |
| 241 | + | subsection (b) of this section shall include: (A) Identification of public 188 | |
| 242 | + | health facilities where services may be provided and the populations 189 | |
| 243 | + | to be served; (B) any limitations on the services that may be provided 190 | |
| 244 | + | by the advanced practice dental therapist; (C) age and procedure-191 | |
| 245 | + | specific practice protocols, including case selection criteria, assessment 192 | |
| 246 | + | guidelines and imaging frequency; (D) a procedure for creating and 193 | |
| 247 | + | maintaining dental records for the patients that are treated by the 194 | |
| 248 | + | advanced practice dental therapist; (E) a plan to manage medical 195 | |
| 249 | + | emergencies in each public health facility where the advanced practice 196 | |
| 250 | + | dental therapist provides care; (F) a quality assurance plan for 197 | |
| 251 | + | monitoring care provided by the advanced practice dental therapist, 198 | |
| 252 | + | including patient care review, referral follow-up and a quality 199 | |
| 253 | + | assurance chart review; (G) protocols for dispensing and administering 200 | |
| 254 | + | medications, including the specific conditions and circumstances 201 | |
| 255 | + | under which these medications may be dispensed and administered; 202 | |
| 256 | + | (H) criteria relating to the provision of care to patients with specific 203 | |
| 257 | + | medical conditions or complex medication histories, including 204 | |
| 258 | + | requirements for consultation prior to the initiation of care; (I) criteria 205 | |
| 259 | + | for the supervision of dental assistants, expanded function dental 206 | |
| 260 | + | assistants, as defined in section 20-112a of the general statutes, as 207 | |
| 261 | + | amended by this act, and dental hygienists in accordance with 208 | |
| 262 | + | subsection (g) of this section; and (J) a plan for the provision of 209 | |
| 263 | + | referrals in situations that are beyond the capabilities or the scope of 210 | |
| 264 | + | practice of the advanced practice dental therapist. 211 | |
| 265 | + | (2) A collaborative agreement shall be (A) signed and maintained by 212 | |
| 266 | + | the supervising dentist and the advanced practice dental therapist and 213 | |
| 267 | + | kept on file at the locations where such advanced practice dental 214 | |
| 268 | + | therapist is employed, (B) reviewed by the dentist and advanced 215 | |
| 269 | + | practice dental therapist on an annual basis and revised as needed, and 216 Substitute Bill No. 7303 | |
| 333 | 270 | ||
| 334 | - | Public Act No. 19-72 11 of 12 | |
| 335 | 271 | ||
| 336 | - | president's designee, and (6) a representative of (A) the American | |
| 337 | - | Dental Association's Commission on Dental Accreditation, (B) the Joint | |
| 338 | - | Commission on National Dental Examinations, (C) the Community | |
| 339 | - | Health Center Association of Connecticut, (D) the Connecticut Oral | |
| 340 | - | Health Initiative, (E) the Connecticut Association of School Based | |
| 341 | - | Health Centers, (F) the Connecticut Public Health Association, (G) the | |
| 342 | - | Connecticut Dental Health Partnership, and (H) the Community | |
| 343 | - | Health Center, Inc. The working group may also include members of | |
| 344 | - | such joint standing committee. The chairpersons of such joint standing | |
| 345 | - | committee may convene the working group without the participation | |
| 346 | - | of any individual or representative required pursuant to this section. | |
| 347 | - | The working group shall evaluate and make recommendations | |
| 348 | - | regarding the scope of practice of a dental therapist and the | |
| 349 | - | educational requirements and training requirements that a person | |
| 350 | - | shall meet to become licensed as a dental therapist by the Department | |
| 351 | - | of Public Health. On or before January 1, 2020, the working group shall | |
| 352 | - | report, in accordance with the provisions of section 11-4a of the general | |
| 353 | - | statutes, to such joint standing committee regarding its findings and | |
| 354 | - | recommendations. | |
| 355 | - | Sec. 11. (NEW) (Effective July 1, 2019) (a) As used in this section: | |
| 356 | - | (1) "Point-of-service test" means diagnostic testing performed at the | |
| 357 | - | site where patients will receive care or treatment; and | |
| 358 | - | (2) "HbA1c percentage" means the proportion of hemoglobin to | |
| 359 | - | which glucose is attached and measures the average circulating blood | |
| 360 | - | glucose level over the previous two to three-month period. | |
| 361 | - | (b) A dentist licensed under chapter 379 of the general statutes may, | |
| 362 | - | during an office visit or prior to a procedure and with a patient's | |
| 363 | - | consent, administer an in-office point-of-service test to the patient to | |
| 364 | - | measure the patient's HbA1c percentage utilizing a finger-stick | |
| 365 | - | measurement tool if such patient is at an increased risk of diabetes and Substitute House Bill No. 7303 | |
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| 366 | 275 | ||
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| 276 | + | (C) available for inspection upon the request of the Department of 217 | |
| 277 | + | Public Health. 218 | |
| 278 | + | (f) A dentist who enters into a collaborative agreement with an 219 | |
| 279 | + | advanced practice dental therapist (1) shall be professionally 220 | |
| 280 | + | responsible and legally liable for all services authorized and performed 221 | |
| 281 | + | by an advanced practice dental therapist pursuant to a collaborative 222 | |
| 282 | + | agreement, and (2) may not enter into a collaborative agreement with 223 | |
| 283 | + | more than two advanced practice dental therapists at any one time. 224 | |
| 284 | + | Nothing in this section shall be construed to require a dentist to enter 225 | |
| 285 | + | into a collaborative agreement with an advanced practice dental 226 | |
| 286 | + | therapist. 227 | |
| 287 | + | (g) An advanced practice dental therapist may directly supervise 228 | |
| 288 | + | not more than two dental assistants or expanded function dental 229 | |
| 289 | + | assistants, as defined in section 20-112a of the general statutes, as 230 | |
| 290 | + | amended by this act, or dental hygienists licensed pursuant to chapter 231 | |
| 291 | + | 379a of the general statutes to the extent permitted in the collaborative 232 | |
| 292 | + | agreement. 233 | |
| 293 | + | (h) (1) Upon each renewal of a dental hygiene license pursuant to 234 | |
| 294 | + | chapter 379a of the general statutes, each advanced practice dental 235 | |
| 295 | + | therapist shall complete six hours of continuing education in addition 236 | |
| 296 | + | to the continuing education requirements of subsection (g) of section 237 | |
| 297 | + | 20-126l of the general statutes, as amended by this act, for a total of six 238 | |
| 298 | + | hours of continuing education during a dental hygienist's first license 239 | |
| 299 | + | renewal period and for a total of twenty-two hours of continuing 240 | |
| 300 | + | education during each renewal period thereafter. 241 | |
| 301 | + | (2) Each advanced practice dental therapist applying for a renewal 242 | |
| 302 | + | of a dental hygiene license pursuant to chapter 379a of the general 243 | |
| 303 | + | statutes and in accordance with section 19a-88 of the general statutes 244 | |
| 304 | + | shall sign a statement attesting that he or she has satisfied the 245 | |
| 305 | + | continuing education requirements described in subdivision (1) of this 246 | |
| 306 | + | subsection on a form prescribed by the Department of Public Health. 247 | |
| 307 | + | Each advanced practice dental therapist shall retain records of 248 Substitute Bill No. 7303 | |
| 368 | 308 | ||
| 369 | - | does not have a previous diagnosis of diabetes. A dentist who does not | |
| 370 | - | administer such test pursuant to this section shall not be deemed to | |
| 371 | - | have violated the standard of care for a dentist. The Commissioner of | |
| 372 | - | Public Health may adopt regulations in accordance with the provisions | |
| 373 | - | of chapter 54 of the general statutes to carry out the provisions of this | |
| 374 | - | section. | |
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| 313 | + | ||
| 314 | + | attendance or certificates of completion that demonstrate compliance 249 | |
| 315 | + | with the continuing education requirements described in subdivision 250 | |
| 316 | + | (1) of this subsection for not less than three years following the date on 251 | |
| 317 | + | which the continuing education was completed or the license was 252 | |
| 318 | + | renewed. Each advanced practice dental therapist shall submit such 253 | |
| 319 | + | records to the department for inspection not later than forty-five days 254 | |
| 320 | + | after a request by the department for such records. An advanced 255 | |
| 321 | + | practice dental therapist who fails to comply with the provisions of 256 | |
| 322 | + | this section may be subject to disciplinary action pursuant to section 257 | |
| 323 | + | 20-126o of the general statutes, as amended by this act. 258 | |
| 324 | + | Sec. 5. Subsection (a) of section 20-126o of the general statutes is 259 | |
| 325 | + | repealed and the following is substituted in lieu thereof (Effective 260 | |
| 326 | + | January 1, 2020): 261 | |
| 327 | + | (a) The Department of Public Health may take any of the actions set 262 | |
| 328 | + | forth in section 19a-17 for any of the following causes: (1) The 263 | |
| 329 | + | presentation to the department of any diploma, license or certificate 264 | |
| 330 | + | illegally or fraudulently obtained, or obtained from an institution that 265 | |
| 331 | + | is not accredited or from an unrecognized or irregular institution or 266 | |
| 332 | + | state board, or obtained by the practice of any fraud or deception; (2) 267 | |
| 333 | + | illegal conduct; (3) negligent, incompetent or wrongful conduct in 268 | |
| 334 | + | professional activities; (4) conviction of the violation of any of the 269 | |
| 335 | + | provisions of sections 20-126h to 20-126w, inclusive, or section 4 of this 270 | |
| 336 | + | act by any court of criminal jurisdiction; (5) the violation of any of the 271 | |
| 337 | + | provisions of said sections or of the regulations adopted hereunder or 272 | |
| 338 | + | the refusal to comply with any of said provisions or regulations; (6) the 273 | |
| 339 | + | aiding or abetting in the practice of dental hygiene of a person not 274 | |
| 340 | + | licensed to practice dental hygiene in this state; (7) engaging in fraud 275 | |
| 341 | + | or material deception in the course of professional activities; (8) the 276 | |
| 342 | + | effects of physical or mental illness, emotional disorder or loss of 277 | |
| 343 | + | motor skill, including, but not limited to, deterioration through the 278 | |
| 344 | + | aging process, upon the license holder; (9) abuse or excessive use of 279 | |
| 345 | + | drugs, including alcohol, narcotics or chemicals; or (10) failure to 280 | |
| 346 | + | provide information to the Department of Public Health required to 281 Substitute Bill No. 7303 | |
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| 353 | + | complete a health care provider profile, as set forth in section 20-13j. A 282 | |
| 354 | + | violation of any of the provisions of sections 20-126h to 20-126w, 283 | |
| 355 | + | inclusive, or section 4 of this act by any unlicensed employee in the 284 | |
| 356 | + | practice of dental hygiene, with the knowledge of his or her employer, 285 | |
| 357 | + | shall be deemed a violation thereof by his or her employer. The 286 | |
| 358 | + | Commissioner of Public Health may order a license holder to submit to 287 | |
| 359 | + | a reasonable physical or mental examination if his or her physical or 288 | |
| 360 | + | mental capacity to practice safely is the subject of an investigation. Said 289 | |
| 361 | + | commissioner may petition the superior court for the judicial district of 290 | |
| 362 | + | Hartford to enforce such order or any action taken pursuant to said 291 | |
| 363 | + | section 19a-17. 292 | |
| 364 | + | Sec. 6. Section 20-126t of the general statutes is repealed and the 293 | |
| 365 | + | following is substituted in lieu thereof (Effective January 1, 2020): 294 | |
| 366 | + | Any person who violates any provision of sections 20-126h to 20-295 | |
| 367 | + | 126w, inclusive, or section 4 of this act shall be guilty of a class D 296 | |
| 368 | + | felony. Any person who continues to practice dental hygiene or engage 297 | |
| 369 | + | as a dental hygienist, after his license or authority to so do has been 298 | |
| 370 | + | suspended or revoked and while such disability continues, shall be 299 | |
| 371 | + | guilty of a class D felony. For the purposes of this section, each 300 | |
| 372 | + | instance of patient contact or consultation which is in violation of any 301 | |
| 373 | + | provision of this section shall constitute a separate offense. Failure to 302 | |
| 374 | + | renew a license in a timely manner shall not constitute a violation for 303 | |
| 375 | + | the purposes of this section. 304 | |
| 376 | + | Sec. 7. Subsections (c) and (d) of section 20-112a of the general 305 | |
| 377 | + | statutes are repealed and the following is substituted in lieu thereof 306 | |
| 378 | + | (Effective January 1, 2020): 307 | |
| 379 | + | (c) (1) A licensed dentist may delegate to dental assistants such 308 | |
| 380 | + | dental procedures as the dentist may deem advisable, including: (A) 309 | |
| 381 | + | The taking of dental x-rays if the dental assistant can demonstrate 310 | |
| 382 | + | successful completion of the dental radiation health and safety 311 | |
| 383 | + | examination administered by the Dental Assisting National Board; (B) 312 | |
| 384 | + | the taking of impressions of teeth for study models; and (C) the 313 Substitute Bill No. 7303 | |
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| 391 | + | provision of fluoride varnish treatments. Such procedures shall be 314 | |
| 392 | + | performed under the direct supervision of a licensed dentist and the 315 | |
| 393 | + | dentist providing direct supervision shall assume responsibility for 316 | |
| 394 | + | such procedures. 317 | |
| 395 | + | (2) A licensed dentist may delegate to an expanded function dental 318 | |
| 396 | + | assistant such dental procedures as the dentist may deem advisable, 319 | |
| 397 | + | including: (A) The placing, finishing and adjustment of temporary 320 | |
| 398 | + | restorations and long-term individual fillings, capping materials and 321 | |
| 399 | + | cement bases; (B) oral health education for patients; (C) dental sealants; 322 | |
| 400 | + | [and] (D) coronal polishing, provided the procedure is not represented 323 | |
| 401 | + | or billed as prophylaxis; (E) administration of topical anesthetic under 324 | |
| 402 | + | the direct supervision of the dentist prior to the administration of local 325 | |
| 403 | + | anesthetic by a dentist or dental hygienist; and (F) taking alginate 326 | |
| 404 | + | impressions of teeth, under the direct supervision of the dentist, for 327 | |
| 405 | + | use in study models, orthodontic appliances, whitening trays, mouth 328 | |
| 406 | + | guards or fabrication of temporary crowns. Such procedures shall be 329 | |
| 407 | + | performed under [the] either direct or indirect supervision, except as 330 | |
| 408 | + | specifically provided in this subdivision, and the dentist providing 331 | |
| 409 | + | such supervision shall assume responsibility for such procedures. 332 | |
| 410 | + | (3) On or after July 1, 2018, (A) no licensed dentist may delegate 333 | |
| 411 | + | dental procedures to a dental assistant or expanded function dental 334 | |
| 412 | + | assistant unless the dental assistant or expanded function dental 335 | |
| 413 | + | assistant provides records demonstrating successful completion of the 336 | |
| 414 | + | Dental Assisting National Board's infection control examination or an 337 | |
| 415 | + | infection control competency assessment administered by a dental 338 | |
| 416 | + | education program in the state that is accredited by the American 339 | |
| 417 | + | Dental Association's Commission on Dental Accreditation, except as 340 | |
| 418 | + | provided in subdivision (2) of this subsection, (B) a dental assistant 341 | |
| 419 | + | may receive not more than [nine] fifteen months of on-the-job training 342 | |
| 420 | + | by a licensed dentist for purposes of preparing the dental assistant for 343 | |
| 421 | + | the Dental Assisting National Board's infection control examination, 344 | |
| 422 | + | and (C) any licensed dentist who delegates dental procedures to a 345 | |
| 423 | + | dental assistant shall retain and make such records available for 346 Substitute Bill No. 7303 | |
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| 429 | + | ||
| 430 | + | inspection upon request of the Department of Public Health. 347 | |
| 431 | + | (4) On and after January 1, 2018, upon successful completion of the 348 | |
| 432 | + | Dental Assisting National Board's infection control examination or an 349 | |
| 433 | + | infection control competency assessment administered by a dental 350 | |
| 434 | + | education program in the state that is accredited by the American 351 | |
| 435 | + | Dental Association's Commission on Dental Accreditation, each dental 352 | |
| 436 | + | assistant or expanded function dental assistant shall complete not less 353 | |
| 437 | + | than one hour of training or education in infection control in a dental 354 | |
| 438 | + | setting every two years, including, but not limited to, courses, 355 | |
| 439 | + | including online courses, offered or approved by a dental school or 356 | |
| 440 | + | another institution of higher education that is accredited or recognized 357 | |
| 441 | + | by the Commission on Dental Accreditation, a regional accrediting 358 | |
| 442 | + | organization, the American Dental Association or a state, district or 359 | |
| 443 | + | local dental association or society affiliated with the American Dental 360 | |
| 444 | + | Association or the American Dental Assistants Association. 361 | |
| 445 | + | (d) [Under] Except as provided in subsection (c) of this section, 362 | |
| 446 | + | under no circumstances may a dental assistant or expanded function 363 | |
| 447 | + | dental assistant engage in: (1) Diagnosis for dental procedures or 364 | |
| 448 | + | dental treatment; (2) the cutting or removal of any hard or soft tissue 365 | |
| 449 | + | or suturing; (3) the prescribing of drugs or medications that require the 366 | |
| 450 | + | written or oral order of a licensed dentist or physician; (4) the 367 | |
| 451 | + | administration of local, parenteral, inhalation or general anesthetic 368 | |
| 452 | + | agents in connection with any dental operative procedure; (5) the 369 | |
| 453 | + | taking of any final impression of the teeth or jaws or the relationship of 370 | |
| 454 | + | the teeth or jaws for the purpose of fabricating any appliance or 371 | |
| 455 | + | prosthesis; or (6) the practice of dental hygiene as defined in section 372 | |
| 456 | + | 20-126l, as amended by this act. 373 | |
| 457 | + | Sec. 8. Subsections (a) and (b) of section 20-126c of the general 374 | |
| 458 | + | statutes are repealed and the following is substituted in lieu thereof 375 | |
| 459 | + | (Effective January 1, 2020): 376 | |
| 460 | + | (a) As used in this section: 377 Substitute Bill No. 7303 | |
| 461 | + | ||
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| 466 | + | ||
| 467 | + | (1) "Commissioner" means the Commissioner of Public Health; 378 | |
| 468 | + | (2) "Contact hour" means a minimum of fifty minutes of continuing 379 | |
| 469 | + | education activity; 380 | |
| 470 | + | (3) "Department" means the Department of Public Health; 381 | |
| 471 | + | (4) "Licensee" means any person who receives a license from the 382 | |
| 472 | + | department pursuant to this chapter; [and] 383 | |
| 473 | + | (5) "Registration period" means the one-year period for which a 384 | |
| 474 | + | license renewed in accordance with section 19a-88 is current and valid; 385 | |
| 475 | + | and 386 | |
| 476 | + | (6) "Temporary dental clinic" means a dental clinic that provides 387 | |
| 477 | + | dental care services at no cost to uninsured or underinsured persons 388 | |
| 478 | + | and operates for not more than seventy-two consecutive hours. 389 | |
| 479 | + | (b) Except as otherwise provided in this section, a licensee applying 390 | |
| 480 | + | for license renewal shall earn a minimum of twenty-five contact hours 391 | |
| 481 | + | of continuing education within the preceding twenty-four-month 392 | |
| 482 | + | period. Such continuing education shall (1) be in an area of the 393 | |
| 483 | + | licensee's practice; (2) reflect the professional needs of the licensee in 394 | |
| 484 | + | order to meet the health care needs of the public; and (3) include not 395 | |
| 485 | + | less than one contact hour of training or education in (A) any three of 396 | |
| 486 | + | the ten mandatory topics for continuing education activities prescribed 397 | |
| 487 | + | by the commissioner pursuant to this subdivision, (B) for registration 398 | |
| 488 | + | periods beginning on and after October 1, 2016, infection control in a 399 | |
| 489 | + | dental setting, and (C) prescribing controlled substances and pain 400 | |
| 490 | + | management. For registration periods beginning on and after October 401 | |
| 491 | + | 1, 2011, the Commissioner of Public Health, in consultation with the 402 | |
| 492 | + | Dental Commission, shall on or before October 1, 2010, and biennially 403 | |
| 493 | + | thereafter, issue a list that includes ten mandatory topics for 404 | |
| 494 | + | continuing education activities that will be required for the following 405 | |
| 495 | + | two-year registration period. Qualifying continuing education 406 | |
| 496 | + | activities include, but are not limited to, courses, including on-line 407 | |
| 497 | + | courses, offered or approved by the American Dental Association or 408 Substitute Bill No. 7303 | |
| 498 | + | ||
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| 503 | + | ||
| 504 | + | state, district or local dental associations and societies affiliated with 409 | |
| 505 | + | the American Dental Association; national, state, district or local dental 410 | |
| 506 | + | specialty organizations or the American Academy of General 411 | |
| 507 | + | Dentistry; a hospital or other health care institution; dental schools and 412 | |
| 508 | + | other schools of higher education accredited or recognized by the 413 | |
| 509 | + | Council on Dental Accreditation or a regional accrediting organization; 414 | |
| 510 | + | agencies or businesses whose programs are accredited or recognized 415 | |
| 511 | + | by the Council on Dental Accreditation; local, state or national medical 416 | |
| 512 | + | associations; a state or local health department; or the Accreditation 417 | |
| 513 | + | Council for Graduate Medical Education. Eight hours of volunteer 418 | |
| 514 | + | dental practice at a public health facility, as defined in section 20-126l, 419 | |
| 515 | + | as amended by this act, or a temporary dental clinic may be 420 | |
| 516 | + | substituted for one contact hour of continuing education, up to a 421 | |
| 517 | + | maximum of ten contact hours in one twenty-four-month period. 422 | |
| 518 | + | Sec. 9. Subsection (a) of section 20-126l of the general statutes is 423 | |
| 519 | + | repealed and the following is substituted in lieu thereof (Effective 424 | |
| 520 | + | January 1, 2020): 425 | |
| 521 | + | (a) As used in this section: 426 | |
| 522 | + | (1) "General supervision of a licensed dentist" means supervision 427 | |
| 523 | + | that authorizes dental hygiene procedures to be performed with the 428 | |
| 524 | + | knowledge of said licensed dentist, whether or not the dentist is on the 429 | |
| 525 | + | premises when such procedures are being performed; 430 | |
| 526 | + | (2) "Public health facility" means an institution, as defined in section 431 | |
| 527 | + | 19a-490, a community health center, a group home, a school, a 432 | |
| 528 | + | preschool operated by a local or regional board of education, a head 433 | |
| 529 | + | start program or a program offered or sponsored by the federal Special 434 | |
| 530 | + | Supplemental Food Program for Women, Infants and Children, a 435 | |
| 531 | + | senior center or a managed residential community, as defined in 436 | |
| 532 | + | section 19a-693, [or] a licensed child care center, as described in section 437 | |
| 533 | + | 19a-77, or a temporary dental clinic, as defined in section 20-126c, as 438 | |
| 534 | + | amended by this act; 439 Substitute Bill No. 7303 | |
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| 540 | + | ||
| 541 | + | (3) The "practice of dental hygiene" means the performance of 440 | |
| 542 | + | educational, preventive and therapeutic services including: Complete 441 | |
| 543 | + | prophylaxis; the removal of calcerous deposits, accretions and stains 442 | |
| 544 | + | from the supragingival and subgingival surfaces of the teeth by 443 | |
| 545 | + | scaling, root planing and polishing; the application of pit and fissure 444 | |
| 546 | + | sealants and topical solutions to exposed portions of the teeth; dental 445 | |
| 547 | + | hygiene examinations and the charting of oral conditions; dental 446 | |
| 548 | + | hygiene assessment, treatment planning and evaluation; the 447 | |
| 549 | + | administration of local anesthesia in accordance with the provisions of 448 | |
| 550 | + | subsection (d) of this section; taking alginate impressions of teeth, 449 | |
| 551 | + | under the indirect supervision of a dentist, for use in study models, 450 | |
| 552 | + | orthodontic appliances, whitening trays, mouth guards and fabrication 451 | |
| 553 | + | of temporary crowns; and collaboration in the implementation of the 452 | |
| 554 | + | oral health care regimen; and 453 | |
| 555 | + | (4) "Contact hour" means a minimum of fifty minutes of continuing 454 | |
| 556 | + | education activity. 455 | |
| 557 | + | Sec. 10. Subsection (g) of section 20-126l of the general statutes is 456 | |
| 558 | + | repealed and the following is substituted in lieu thereof (Effective 457 | |
| 559 | + | January 1, 2020): 458 | |
| 560 | + | (g) Each licensed dental hygienist applying for license renewal shall 459 | |
| 561 | + | earn a minimum of sixteen contact hours of continuing education 460 | |
| 562 | + | within the preceding twenty-four-month period, including, for 461 | |
| 563 | + | registration periods beginning on and after October 1, 2016, at least 462 | |
| 564 | + | one contact hour of training or education in infection control in a 463 | |
| 565 | + | dental setting and, for registration periods beginning on and after 464 | |
| 566 | + | October 1, 2017, at least one contact hour of training or education in 465 | |
| 567 | + | cultural competency. The subject matter for continuing education shall 466 | |
| 568 | + | reflect the professional needs of the licensee in order to meet the health 467 | |
| 569 | + | care needs of the public. Continuing education activities shall provide 468 | |
| 570 | + | significant theoretical or practical content directly related to clinical or 469 | |
| 571 | + | scientific aspects of dental hygiene. Qualifying continuing education 470 | |
| 572 | + | activities include, but are not limited to, courses, including on-line 471 | |
| 573 | + | courses, that are offered or approved by dental schools and other 472 Substitute Bill No. 7303 | |
| 574 | + | ||
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| 579 | + | ||
| 580 | + | institutions of higher education that are accredited or recognized by 473 | |
| 581 | + | the Council on Dental Accreditation, a regional accrediting 474 | |
| 582 | + | organization, the American Dental Association, a state, district or local 475 | |
| 583 | + | dental association or society affiliated with the American Dental 476 | |
| 584 | + | Association, the National Dental Association, the American Dental 477 | |
| 585 | + | Hygienists Association or a state, district or local dental hygiene 478 | |
| 586 | + | association or society affiliated with the American Dental Hygienists 479 | |
| 587 | + | Association, the Academy of General Dentistry, the Academy of 480 | |
| 588 | + | Dental Hygiene, the American Red Cross or the American Heart 481 | |
| 589 | + | Association when sponsoring programs in cardiopulmonary 482 | |
| 590 | + | resuscitation or cardiac life support, the United States Department of 483 | |
| 591 | + | Veterans Affairs and armed forces of the United States when 484 | |
| 592 | + | conducting programs at United States governmental facilities, a 485 | |
| 593 | + | hospital or other health care institution, agencies or businesses whose 486 | |
| 594 | + | programs are accredited or recognized by the Council on Dental 487 | |
| 595 | + | Accreditation, local, state or national medical associations, or a state or 488 | |
| 596 | + | local health department. Eight hours of volunteer dental practice at a 489 | |
| 597 | + | public health facility, as defined in subsection (a) of this section, may 490 | |
| 598 | + | be substituted for one contact hour of continuing education, up to a 491 | |
| 599 | + | maximum of five contact hours in one two-year period. Activities that 492 | |
| 600 | + | do not qualify toward meeting these requirements include professional 493 | |
| 601 | + | organizational business meetings, speeches delivered at luncheons or 494 | |
| 602 | + | banquets, and the reading of books, articles, or professional journals. 495 | |
| 603 | + | [Not more than four contact hours of continuing education may be 496 | |
| 604 | + | earned through an on-line or other distance learning program.] 497 | |
| 605 | + | Sec. 11. Section 20-126l of the general statutes is amended by adding 498 | |
| 606 | + | subsection (l) as follows (Effective January 1, 2020): 499 | |
| 607 | + | (NEW) (l) No provision of chapter 379a shall be construed to 500 | |
| 608 | + | prohibit a student of dental hygiene enrolled in a dental hygiene 501 | |
| 609 | + | program, as described in section 20-126i, from performing dental 502 | |
| 610 | + | hygiene work as a required component of his or her course of study in 503 | |
| 611 | + | such program, provided the student (1) performs such work under the 504 | |
| 612 | + | direct supervision of a dentist licensed pursuant to chapter 379 or a 505 Substitute Bill No. 7303 | |
| 613 | + | ||
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| 618 | + | ||
| 619 | + | dental hygienist licensed pursuant to chapter 379a, (2) shall not hold 506 | |
| 620 | + | himself or herself out as a licensed dental hygienist, and (3) shall not 507 | |
| 621 | + | receive compensation for such work. 508 | |
| 622 | + | Sec. 12. (Effective July 1, 2019) The chairpersons of the joint standing 509 | |
| 623 | + | committee of the General Assembly having cognizance of matters 510 | |
| 624 | + | relating to public health shall convene a working group to advise said 511 | |
| 625 | + | joint standing committee regarding the certification of dental 512 | |
| 626 | + | therapists by the Department of Public Health. The working group 513 | |
| 627 | + | shall be comprised of the chairpersons of said joint standing 514 | |
| 628 | + | committee, or the chairpersons' designees, the Commissioner of Public 515 | |
| 629 | + | Health, or the commissioner's designee, representatives of the 516 | |
| 630 | + | Connecticut State Dental Association, including, but not limited to, at 517 | |
| 631 | + | least one dentist and one dental hygienist, a dental therapist certified 518 | |
| 632 | + | in another state, an advanced practice dental therapist certified in 519 | |
| 633 | + | another state, the president of the Board of Regents for Higher 520 | |
| 634 | + | Education, or the president's designee, a representative of the 521 | |
| 635 | + | Connecticut Conference of Independent Colleges, a representative of 522 | |
| 636 | + | the American Dental Association's Commission on Dental 523 | |
| 637 | + | Accreditation and a representative of the Joint Commission on 524 | |
| 638 | + | National Dental Examinations. The working group may also include 525 | |
| 639 | + | members of said joint standing committee. The working group shall 526 | |
| 640 | + | evaluate and make recommendations regarding the scope of practice 527 | |
| 641 | + | of a dental therapist and the educational requirements and training 528 | |
| 642 | + | requirements that a person shall meet to become certified as a dental 529 | |
| 643 | + | therapist by the Department of Public Health. On or before January 1, 530 | |
| 644 | + | 2020, the working group shall report, in accordance with the 531 | |
| 645 | + | provisions of section 11-4a of the general statutes, to said joint standing 532 | |
| 646 | + | committee regarding its findings and recommendations. 533 | |
| 647 | + | Sec. 13. (NEW) (Effective July 1, 2019) (a) As used in this section: 534 | |
| 648 | + | (1) "Point-of-service test" means diagnostic testing performed at the 535 | |
| 649 | + | site where patients will receive care or treatment; and 536 | |
| 650 | + | (2) "HbA1c percentage" means the proportion of hemoglobin to 537 Substitute Bill No. 7303 | |
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| 656 | + | ||
| 657 | + | which glucose is attached and measures the average circulating blood 538 | |
| 658 | + | glucose level over the previous two to three-month period. 539 | |
| 659 | + | (b) A dentist licensed under chapter 379 of the general statutes may, 540 | |
| 660 | + | during an office visit or prior to a procedure and with a patient's 541 | |
| 661 | + | consent, administer an in-office point-of-service test to the patient to 542 | |
| 662 | + | measure the patient's HbA1c percentage utilizing a finger-stick 543 | |
| 663 | + | measurement tool if such patient is at an increased risk of diabetes and 544 | |
| 664 | + | does not have a previous diagnosis of diabetes. A dentist who does not 545 | |
| 665 | + | administer such test pursuant to this section shall not be deemed to 546 | |
| 666 | + | have violated the standard of care for a dentist. The Commissioner of 547 | |
| 667 | + | Public Health may adopt regulations in accordance with the provisions 548 | |
| 668 | + | of chapter 54 of the general statutes to carry out the provisions of this 549 | |
| 669 | + | section. 550 | |
| 670 | + | This act shall take effect as follows and shall amend the following | |
| 671 | + | sections: | |
| 672 | + | ||
| 673 | + | Section 1 January 1, 2020 20-107 | |
| 674 | + | Sec. 2 January 1, 2020 20-108 | |
| 675 | + | Sec. 3 January 1, 2020 20-110 | |
| 676 | + | Sec. 4 January 1, 2020 New section | |
| 677 | + | Sec. 5 January 1, 2020 20-126o(a) | |
| 678 | + | Sec. 6 January 1, 2020 20-126t | |
| 679 | + | Sec. 7 January 1, 2020 20-112a(c) and (d) | |
| 680 | + | Sec. 8 January 1, 2020 20-126c(a) and (b) | |
| 681 | + | Sec. 9 January 1, 2020 20-126l(a) | |
| 682 | + | Sec. 10 January 1, 2020 20-126l(g) | |
| 683 | + | Sec. 11 January 1, 2020 20-126l | |
| 684 | + | Sec. 12 July 1, 2019 New section | |
| 685 | + | Sec. 13 July 1, 2019 New section | |
| 686 | + | ||
| 687 | + | Statement of Legislative Commissioners: | |
| 688 | + | In Section 4(a)(1), "to dentists, physicians and other health care | |
| 689 | + | providers" was added to Subpara. (A), "in the oral cavity" was added | |
| 690 | + | to Subparas. (H) and (L) and "dental" was added to Subpara. (U) for | |
| 691 | + | accuracy and clarity; in Section 4(b)(2)(A), "Dental Therapy Standards" | |
| 692 | + | was changed to "accreditation standards for dental therapy education | |
| 693 | + | programs" for accuracy; in Section 4(b)(5), "with a dentist" was added Substitute Bill No. 7303 | |
| 694 | + | ||
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| 699 | + | ||
| 700 | + | for clarity; in Section 4(e)(1), ", expanded function dental assistants, as | |
| 701 | + | defined in Section 20-112a of the general statutes, as amended by this | |
| 702 | + | act," was added to Subpara. (I) and "or the scope of practice" was | |
| 703 | + | added to Subpara. (J) for accuracy and clarity; in Section 4(h)(1), | |
| 704 | + | "continuing education" was added for clarity and, "for a total of | |
| 705 | + | twenty-two hours of continuing education within the preceding | |
| 706 | + | twenty-four-month period" was changed to "for a total of six hours of | |
| 707 | + | continuing education during a dental hygienist's first license renewal | |
| 708 | + | period and for a total of twenty-two hours of continuing education | |
| 709 | + | during each renewal period thereafter" for statutory consistency; in | |
| 710 | + | Section 7(c)(4), "or an infection control competency assessment | |
| 711 | + | administered by a dental education program in the state that is | |
| 712 | + | accredited by the American Dental Association's Commission on | |
| 713 | + | Dental Accreditation" was added for consistency and clarity; the | |
| 714 | + | effective date of Section 12 was changed to, "July 1, 2019" for | |
| 715 | + | consistency with the reporting deadline of said section; and Sections 7 | |
| 716 | + | and 14 were combined and Section 14 was deleted to eliminate | |
| 717 | + | redundancy. | |
| 718 | + | ||
| 719 | + | ||
| 720 | + | PH Joint Favorable Subst. | |
| 375 | 721 |