District Of Columbia 2023-2024 Regular Session

District Of Columbia Council Bill B25-0632 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	MURIEL BOWSER
2	2	MAYOR
3	3	December 13, 2023
4	4	The Honorable Phil Mendelson
5	5	Chairman
6	6	Council of the District of Columbia
7	7	John A. Wilson Building
8	8	1350 Pennsylvania Avenue, N.W., Suite 504
9	9	Washington, D.C. 20004
10	10	Dear Chairman Mendelson:
11	11	Enclosed for consideration and approval by the Council is the Dental Specialties Licensure and
12	12	Scope of Practice Amendment Act of 2023. This legislation will amend the Health Occupations
13	13	Revision Act of 1985 to authorize the Board of Dentistry to license and regulate the practice of
14	14	and advertising of dental specialties in the District of Columbia, to define the practice of oral and
15	15	maxillofacial surgeons, and to amend the scope of practice of dentistry to authorize dentists to
16	16	administer immunizations and vaccinations when certified by the Board of Dentistry to do so, to
17	17	authorize dentists to use botulinum toxin or another neurotoxin approved by the Federal Food
18	18	and Drug Administration for dental-related procedures and to treat a diagnosed dental condition
19	19	when certified by the Board of Dentistry to do so, to further define and clarify what constitutes
20	20	the unlicensed practice of dentistry by managers, proprietors, operators, or conductors of a dental
21	21	office, and to authorize disciplinary action against a dental practitioner who enters into an
22	22	agreement or arrangement with a non-dentist or dentist not licensed under the Act that allows the
23	23	non-dentist or dentist not licensed under the Act to directly or indirectly usurp the dental
24	24	practitioner’s professional judgment and clinical treatment of patients through control or
25	25	ownership of the dental practitioner’s office, staff, equipment, patients, or patient records.
26	26	This legislation is necessary to ensure that dentists are appropriately qualified to practice dental
27	27	specialties and to hold themselves out to the public as specialists; to clearly delineate the line
28	28	between dentists and oral and maxillofacial surgeons; and to enable District of Columbia dentists
29	29	to keep up with the expansion of the practice of dentistry across the country and with what is
30	30	taught in dental schools.
31	31	During the public health emergency, dentists were authorized to administer Covid-19
32	32	vaccinations. This legislation will make that expansion of the practice of dentistry part of the
33	33	permanent scope of practice of dentists in the District of Columbia by allowing dentists who
34	34	want to administer vaccinations to receive a certification from the Board to do so. This
35	35	legislation will also expand the practice of dentists in the District of Columbia to be consistent with their counterparts in other states by allowing District of Columbia dentists to administer
36	36	Botox or another FDA approved neurotoxin for dental-related procedures and to treat diagnosed
37	37	dental conditions.
38	38
39	39	This legislation is also necessary to address a loophole in the current law by which non-dentists
40	40	have been circumventing the law that prohibits non-dentists from owning dental offices and
41	41	exercising control over dentists. The current law states that being a “manager,” “proprietor,”
42	42	“operator,” or “conductor” of a dental office is engaging in the practice of dentistry. Non-dentists
43	43	have been circumventing this prohibition by entering into agreements and arrangements with
44	44	dentists in which the non-dentist owns the office space, equipment, practice name, employs the
45	45	staff, and owns the patient roster and patient records. This legislation will close that loophole and
46	46	hold the dentists accountable for entering into these types of agreements and arrangements.
47	47
48	48	I urge the Council to take prompt and favorable action on the enclosed proposed legislation.
49	49
50	50
51	51	Sincerely,
52	52
53	53
54	54
55	55
56	56	Muriel Bowser 1
57	57	2
58	58	3
59	59	4
60	60	5
61	61	6
62	62	7
63	63	8
64	64	9
65	65	A BILL
66	66	airman Phil Mendelson
67	67	at the request
68	68	of the Mayor
69	69	10 IN THE COUNCIL OF THE DISTRICT OF COLUMBIA
70	70	11
71	71	12
72	72	13
73	73	14
74	74	15 To amend the Health Occupations Revision Act of 1985 to authorize the Board of Dentistry to
75	75	16 license and regulate the practice of and advertising of dental specialties in the District, to
76	76	17 define the practice of oral and maxillofacial surgery, to authorize dentists to administer
77	77	18 immunizations and vaccinations when certified by the Board of Dentistry to do so, to
78	78	19 authorize dentists to use botulinum toxin and other neurotoxins approved by the Food and
79	79	20 Drug Administration
80	80	to treat a diagnosed dental condition when certified by the Board of
81	81	21 Dentistry to do so, and to authorize disciplinary action against a dental practitioner who
82	82	22 enters into an agreement or arrangement with a non-dentist or dentist not licensed under
83	83	23 the act that allows the non-dentist or dentist not licensed under the act to control or own
84	84	24 the dental practitioner's office, staff, equipment, patients, or patient records.
85	85	25
86	86	26 BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this
87	87	27 act may be cited as the "Dental Specialties Licensure and Scope
88	88	of Practice Amendment Act of
89	89	28 2023".
90	90	29 Sec. 2. The District
91	91	of Columbia Health Occupations Revision Act of 1985, effective
92	92	30 March 25, 1986 (D.C. Law 6-99; D.C. Official
93	93	Code§ 3-1201.01 et seq.), is amended as follows:
94	94	31 (a) The table of contents is amended by adding a new section designation to read as
95	95	32 follows:
96	96	33 "Sec. 508c. Dental specialty licenses.".
97	97	34 (b) Section 102 (D.C. Official
98	98	Code§ 3-1201.02) is amended as follows:
99	99	35 (1) Paragraph (5) is amended as follows:
100	100	1 2
101	101
102	102	(A) Subparagraph (B) is amended by striking the phrase “tooth or teeth” 36
103	103	and inserting the phrase “tooth or teeth, or the placement or removal of dental implants” in its 37
104	104	place. 38
105	105	(B) Subparagraph (E) is amended by striking the phrase “properly trained 39
106	106	in the administration of the anesthetic agent” and inserting the phrase “properly trained in the 40
107	107	administration of the anesthetic agent and certified by the Board of Dentistry, if required 41
108	108	pursuant to section 201(g),” in its place. 42
109	109	(C) Subparagraph (J) is amended as follows: 43
110	110	(i) Sub-subparagraph (vii) is amended by striking the semicolon 44
111	111	and inserting the phrase “; and” in its place. 45
112	112	(ii) Sub-subparagraph (viii) is amended by striking the phrase “; 46
113	113	and” and inserting a period in its place. 47
114	114	(iii) Sub-subparagraph (ix) is repealed. 48
115	115	(D) New subparagraphs (K) and (L) are added to read as follows: 49
116	116	“(K) The prescription and administration of immunizations and 50
117	117	vaccinations when certified by the Board of Dentistry to do so; 51
118	118	“(L) The use of botulinum toxin or another neurotoxin approved by the 52
119	119	Food and Drug Administration, to treat a diagnosed dental condition approved by the Mayor 53
120	120	through rulemaking, when certified by the Board of Dentistry to do so.”. 54
121	121	(2) Paragraph (10A) is redesignated as paragraph (10B). 55
122	122	(3) A new paragraph (10A) is added to read as follows: 56
123	123	“(10A) “Practice of oral and maxillofacial surgery” means a specialty of the 57
124	124	practice of dentistry that includes the diagnosis, surgical, and adjunctive treatment of disease, 58 3
125	125
126	126	injuries and defects involving both the functional and aesthetic aspects of the hard and soft 59
127	127	tissues of the oral and maxillofacial region, including cosmetic and aesthetic procedures.”. 60
128	128	(c) Section 501 (D.C. Official Code § 3-1205.01) is amended by striking the word 61
129	129	“optometry” and inserting the phrase “optometry, oral and maxillofacial surgery” in its place. 62
130	130	(d) A new section 508c is added to read as follows: 63
131	131	“Sec. 508c. Dental specialty licenses. 64
132	132	“(a) A licensed dentist may not represent to the public that the licensee is a specialist in 65
133	133	any field of specialized dental practice, including oral and maxillofacial surgery, unless licensed 66
134	134	by the Board as a specialist in that dental specialty field. 67
135	135	“(b) The Board may approve any area of specialty recognized by the National 68
136	136	Commission on Recognition of Dental Specialties and Certifying Boards or its successor, or any 69
137	137	other entity approved by the Board that recognizes or certifies a field of specialized dental 70
138	138	practice. 71
139	139	“(c) A dentist shall be eligible for a license in a field of specialized dental practice if the 72
140	140	dentist establishes to the satisfaction of the Board that he or she: 73
141	141	“(1) Is licensed in good standing to practice dentistry in the District; 74
142	142	“(2)(A) Is a Diplomate of a specialty certifying board recognized by the American 75
143	143	Dental Association, is certified by a specialty certifying board recognized by the National 76
144	144	Commission on Recognition of Dental Specialties and Certifying Boards, or is certified by 77
145	145	another entity approved by the Board that that recognizes a field of specialized dental practice; or 78
146	146	“(B) Since a date before January 1, 1986, continuously held himself or 79
147	147	herself out to the public, in an ethical manner, as a specialist in a specialty recognized by the 80
148	148	Board, and 81 4
149	149
150	150	“(3) Meets any other requirements established by the Mayor by rule to assure that 82
151	151	the applicant has had the proper training, experience, and qualifications to be licensed in the 83
152	152	applicable field of specialized dental practice. 84
153	153	“(d) Notwithstanding subsection (a) of this section, for a period of one year following the 85
154	154	effective date of the Dental Specialties Licensure Amendment Act of 2023, a dentist licensed in 86
155	155	good standing by the Board, who is a Diplomate of a specialty certifying board recognized by the 87
156	156	American Dental Association, or certified by a specialty certifying board recognized by the 88
157	157	National Commission on Recognition of Dental Specialties and Certifying Boards, or certified 89
158	158	by another entity approved by the Board that recognizes a field of specialized dental practice, or 90
159	159	who is currently eligible for examination by a national specialty board recognized by the Board, 91
160	160	may continue to represent to the public that the dentist is a specialist in that specialty whether or 92
161	161	not that person holds a specialty license issued by the Board. 93
162	162	“(e) No dentist shall engage in the practice of oral and maxillofacial surgery unless the 94
163	163	dentist: 95
164	164	“(1) Has successfully completed an oral and maxillofacial residency program 96
165	165	approved by the Commission of Dental Accreditation of the American Dental Association or 97
166	166	another entity, approved by the Board, that approves oral and maxillofacial residency programs; 98
167	167	“(2)(A) Is a Diplomate of a national certifying board recognized by the American 99
168	168	Dental Association; or 100
169	169	“(B) Is a diplomate or the equivalent of a diplomate of another entity, 101
170	170	approved by the Board, that certifies diplomates or the equivalent a diplomate in oral and 102
171	171	maxillofacial surgery; and 103 5
172	172
173	173	“(3) Holds a valid dental specialty license in the field of oral and maxillofacial 104
174	174	surgery issued by the Board of Dentistry.”. 105
175	175	(e) Section 514(a) (D.C. Official Code § 3-1205.14(a)) is amended as follows: 106
176	176	(1) Paragraph (51) is amended by striking the phrase “; or” and inserting a 107
177	177	semicolon in its place. 108
178	178	(2) Paragraph (52) is amended by striking the period at the end and inserting the 109
179	179	phrase “; or” in its place. 110
180	180	(3) A new paragraph (53) is added to read as follows: 111
181	181	“(53) Enters into an agreement, arrangement, or relationship with an individual or 112
182	182	entity who is not licensed to practice dentistry under this act, or is not exempted from licensure 113
183	183	as a dentist under this act, in which the individual or entity that is not licensed to practice 114
184	184	dentistry under this act or is not exempted from licensure as a dentist under this act: 115
185	185	“(A) Retains ownership or control of dental office space, dental 116
186	186	equipment, or dental materials; 117
187	187	“(B) Employs or contracts with dentists, dental hygienists, or clinical 118
188	188	dental staff to provide dental services; or 119
189	189	“(C) Exercises control over the selection of a course of dental treatment 120
190	190	for a patient, or the dental procedures or materials to be used as part of such course of treatment, 121
191	191	or the manner in which such course of treatment is carried out by a dentist, dental hygienist, or 122
192	192	other dental staff member, or patient records.”. 123
193	193	Sec. 4. Fiscal impact statement. 124 6
194	194
195	195	The Council adopts the fiscal impact statement in the committee report as the fiscal 125
196	196	impact statement required by section 4a of the General Legislative Procedures Act of 1975, 126
197	197	approved October 16, 2006 (120 Stat. 2038; D.C. Official Code § 1-301.47a). 127
198	198	Sec. 5. Effective date. 128
199	199	This act shall take effect following approval by the Mayor (or in the event of veto by the 129
200	200	Mayor, action by the Council to override the veto), a 30-day period of Congressional review as 130
201	201	provided in section 602(c)(1) of the District of Columbia Home Rule Act, approved December 131
202	202	24, 1973 (87 Stat. 813; D.C. Official Code § 1-206.02(c)(1)), and publication in the District of 132
203	203	Columbia Register. 133 3
204	204	GOVERNMENT OF THE DISTRICT OF COLUMBIA
205	205	OFFICE OF THE ATTORNEY GENERAL
206	206	BRIANL.SCHWALB
207	207	ATTORNEYGENERALL
208	208	EGAL
209	209	C
210	210	OUNSEL
211	211	D
212	212	IVISION
213	213	MEMORANDUM
214	214	TO: Tommy Wells
215	215	Director
216	216	Office of Policy and Legislative Affairs
217	217	FROM: Megan D. Browder
218	218	Deputy Attorney General
219	219	Legal Counsel Division
220	220	DATE: February 17, 2023
221	221	SUBJECT: Legal Sufficiency ReviewofDraft Legislation, the “Dental Specialties Licensure and
222	222	Scope of Practice Amendment Act of 2023”
223	223	(AE-23-055)
224	224	________________________________________________________________________
225	225	This is to Certify that
226	226	this Office has reviewed the above-referenced
227	227	legislationand that we have found it to be legally sufficient. If you have any questions in this
228	228	regard, please do not hesitate to call me at 724-5524.
229	229	________________________________
230	230	Megan D. Browder Government of the District of Columbia
231	231	Office of the Chief Financial Officer
232	232
233	233	Glen Lee
234	234	Chief Financial Officer
235	235
236	236
237	237
238	238
239	239
240	240	1350 Pennsylvania Avenue, NW, Suite 203, Washington, DC 20004 (202)727-2476
241	241	www.cfo.dc.gov
242	242	MEMORANDUM
243	243
244	244	TO: The Honorable Phil Mendelson
245	245	Chairman, Council of the District of Columbia
246	246
247	247	FROM: Glen Lee
248	248	Chief Financial Officer
249	249
250	250	DATE: November 1, 2023
251	251
252	252	SUBJECT: Fiscal Impact Statement – Dental Specialties Licensure and Scope of
253	253	Practice Amendment Act of 2023
254	254
255	255	REFERENCE: Draft introduction as provided to the Office of Revenue Analysis on
256	256	October 27, 2023
257	257
258	258
259	259	Conclusion
260	260
261	261	Funds are sufficient in the fiscal year 2024 through fiscal year 2027 budget and financial plan to
262	262	implement the bill.
263	263
264	264	Background
265	265
266	266	The bill clarifies
267	267	1 and expands the scope of practice for dentists in the District of Columbia to allow
268	268	for the administration of immunizations and vaccinations when certified to do so by the Board of
269	269	Dentistry. The bill also authorizes dentists to use botulinum toxin and other neurotoxins that are
270	270	approved by the Food and Drug Administration to treat certain dental conditions.
271	271
272	272	The bill authorizes
273	273	2 the Board of Dentistry to license and regulate the practice and advertising of any
274	274	area of dental specialty recognized by the National Commission on Recognition of Dental Specialties
275	275	including the practice of oral and maxillofacial surgery.
276	276	3 In order to be licensed in a field of specialized
277	277	dental practice, dentists must be either licensed in good standing to practice dentistry in the District,
278	278
279	279	1
280	280	By amending The District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986
281	281	(D.C. Law 6-99; D.C. Official Code § 3-1201.01 et seq.).
282	282	2
283	283	Id.
284	284	3
285	285	The practice of oral and maxillofacial surgery includes the diagnosis, surgical, and adjunctive treatment of
286	286	disease, injuries, and defects involving both the functional and aesthetic aspects of the hard and soft tissues of
287	287	the oral and maxillofacial region, including cosmetic and aesthetic procedures. The Honorable Phil Mendelson
288	288	FIS: “Dental Specialties Licensure and Scope of Practice Amendment Act of 2023,” Draft introduction as
289	289	provided to the Office of Revenue Analysis on October 27, 2023
290	290	Page 2 of 2
291	291
292	292	be a diplomate of a specialty certifying board recognized by the American Dental Association, be
293	293	certified by a specialty certifying board recognized by the National Commission on Recognition of
294	294	Dental Specialties and Certifying Boards, or be certified by another entity approved by the Board that
295	295	recognizes a field of specialized dental practice. No dentists can engage in the practice of oral and
296	296	maxillofacial surgery unless the dentist has successfully completed an oral and maxillofacial
297	297	residency program, is a Diplomate of a national certifying board recognized by the American Dental
298	298	Association, or is a diplomate or the equivalent of a diplomate of another entity approved by the
299	299	Board of Dentistry.
300	300
301	301	The bill also authorizes
302	302	4 disciplinary action against dental practitioners who enter into agreements
303	303	or arrangements with non-dentists or dentists not licensed in the District to control or own the dental
304	304	practitioner’s office, staff, equipment, patients, or patient records.
305	305
306	306
307	307	Financial Plan Impact
308	308
309	309	Funds are sufficient in the fiscal year 2024 through fiscal year 2027 budget and financial plan to
310	310	implement the bill.
311	311
312	312	There is no cost to expanding the scope of the practice for dentists to include administering
313	313	vaccinations and to administer neurotoxins to treat certain dental conditions. The Board of Dentistry
314	314	already regulates the practice of dentistry in the District. Likewise, allowing for the licensing and
315	315	regulation of dental specialties does not have a cost. The Board of Dentistry estimates that fifty
316	316	individuals that are already licensed to practice dentistry in the District will apply for specialty
317	317	dentist licenses.
318	318
319	319	The Board of Dentistry is already authorized to take disciplinary action against practitioners that do
320	320	not comply with District law. Expanding the Board’s authority to take disciplinary action against
321	321	certain practitioners does not have a cost.
322	322
323	323
324	324
325	325
326	326
327	327	4
328	328	By amending D.C. Official Code § 3-1205.14(a).