(Reprinted with amendments adopted on April 13, 2023) FIRST REPRINT S.B. 44 - *SB44_R1* SENATE BILL NO. 44–COMMITTEE ON HEALTH AND HUMAN SERVICES (ON BEHALF OF THE DIVISION OF PUBLIC AND BEHAVIORAL HEALTH OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES) PREFILED NOVEMBER 16, 2022 ____________ Referred to Committee on Health and Human Services SUMMARY—Revises provisions related to dental and oral health care. (BDR 38-221) FISCAL NOTE: Effect on Local Government: No. Effect on the State: No. ~ EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. AN ACT relating to public health; transferring the State Dental Health Officer from the Division of Health Care Financing and Policy of the Department of Health and Human Services to the Department; revising provisions governing the qualifications for appointment as the State Dental Health Officer or the State Public Health Dental Hygienist; transferring the State Program for Oral Health, the Advisory Committee on the State Program for Oral Health and certain duties from the Division of Public and Behavioral Health of the Department of Health and Human Services to the Department; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law requires the Division of Health Care Financing and Policy of the 1 Department of Health and Human Services to appoint, with the consent of the 2 Director of the Department, a State Dental Health Officer and prescribes 3 the qualifications and duties of the State Dental Health Officer. Existing law also 4 requires the State Dental Health Officer to: (1) hold a current license to practice 5 dentistry issued pursuant to chapter 631 of NRS; and (2) be appointed on the basis 6 of his or her education, training and experience and his or her interest in public 7 dental health and related programs. Finally, existing law requires the State Dental 8 Health Officer to devote all of his or her time to the business of his or her office 9 – 2 – - *SB44_R1* and prohibits him or her from pursuing any other business or vocation or holding 10 any other office of profit. (NRS 422.239) Section 1 of this bill transfers the duty to 11 appoint the State Dental Health Officer from the Division of Health Care Financing 12 and Policy to the Director of the Department. Section 1 also provides that the State 13 Dental Health Officer must have satisfied the educational requirements for and 14 may, but is not required to, satisfy any other requirements for the issuance of an 15 unrestricted license to practice dentistry pursuant to chapter 631 of NRS. Finally, 16 section 1 eliminates the requirement that the State Dental Health Officer devote all 17 of his or her time to the business of his or her office and the prohibition on the 18 pursuit of any other business or vocation or holding any other office of profit. 19 Existing law requires the Division of Public and Behavioral Health of the 20 Department of Health and Human Services to appoint, with the consent of the 21 Director of the Department, a State Public Health Dental Hygienist, who must: (1) 22 hold a current license to practice dental hygiene issued pursuant to chapter 631 of 23 NRS with a special endorsement to practice public health dental hygiene; and (2) be 24 appointed on the basis of his or her education, training and experience and his or 25 her interest in public health dental hygiene and related programs. Existing law also 26 requires the State Public Health Dental Hygienist to devote all of his or her time to 27 the business of his or her office and prohibits the State Public Health Dental 28 Hygienist from pursuing any other business or vocation or holding any other office 29 of profit. (NRS 439.279) Section 2 of this bill transfers the duty to appoint the State 30 Public Health Dental Hygienist to the Department and provides that the State 31 Public Health Dental Hygienist may, but is not required to, hold a current license to 32 practice dental hygiene issued pursuant to chapter 631 of NRS with a special 33 endorsement to practice public health dental hygiene. Section 2 also eliminates the 34 requirement that the State Public Health Dental Hygienist devote all of his or her 35 time to the business of his or her office and the prohibition on the pursuit of any 36 other business or vocation or holding any other office of profit. 37 Existing law establishes the State Program for Oral Health within the Division 38 of Public and Behavioral Health. (NRS 439.2791) Section 3 of this bill transfers 39 that Program to the Department. 40 Existing law: (1) creates the Advisory Committee on the State Program for Oral 41 Health within the Division of Public and Behavioral Health; and (2) requires the 42 Advisory Committee to annually submit a written report to the Administrator of the 43 Division summarizing the activities of the Advisory Committee and its 44 recommendations. (NRS 439.2792) Section 4 of this bill: (1) transfers the Advisory 45 Committee to the Department; and (2) requires the Advisory Committee to submit 46 its annual report to the Director of the Department. 47 Existing law prescribes certain duties for the Division of Public and Behavioral 48 Health to perform with the advice and recommendations of the Advisory 49 Committee. (NRS 439.2793) Section 5 of this bill transfers those duties to the 50 Department. 51 Existing law authorizes the Division of Public and Behavioral Health to take 52 certain actions and sets forth certain requirements and duties for the administration 53 of money accepted to carry out the State Program for Oral Health. (NRS 439.2794) 54 Section 6 of this bill transfers that authority and those requirements and duties to 55 the Department. 56 – 3 – - *SB44_R1* THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. NRS 422.239 is hereby amended to read as follows: 1 422.239 1. The [Division of Health Care Financing and 2 Policy of the Department] Director shall appoint [, with the consent 3 of the Director,] a State Dental Health Officer, who may serve in the 4 unclassified service of the State or as a contractor for the [Division.] 5 Department. The State Dental Health Officer must: 6 (a) Be a resident of this State; 7 (b) [Hold a current] Have satisfied the educational 8 requirements for and may, but is not required to, satisfy any other 9 requirements for the issuance of an unrestricted license to practice 10 dentistry [issued] pursuant to chapter 631 of NRS; and 11 (c) Be appointed on the basis of his or her education, training 12 and experience and his or her interest in public dental health and 13 related programs. 14 2. The State Dental Health Officer shall: 15 (a) Determine the needs of the residents of this State for public 16 dental health; 17 (b) Provide the Advisory Committee [, the Division of Health 18 Care Financing and Policy] and the [Division of Public and 19 Behavioral Health] Department with advice regarding public dental 20 health; 21 (c) Make recommendations to the Advisory Committee, the 22 [Division of Health Care Financing and Policy, the Division of 23 Public and Behavioral Health] Department and the Legislature 24 regarding programs in this State for public dental health; 25 (d) Work collaboratively with the State Public Health Dental 26 Hygienist; and 27 (e) Seek such information and advice from the Advisory 28 Committee or from any dental education program in this State, 29 including any such programs of the Nevada System of Higher 30 Education, as necessary to carry out his or her duties. 31 3. [The State Dental Health Officer shall devote all of his or 32 her time to the business of his or her office and shall not pursue any 33 other business or vocation or hold any other office of profit. 34 4.] As used in this section, “Advisory Committee” means the 35 Advisory Committee on the State Program for Oral Health created 36 by NRS 439.2792. 37 Sec. 2. NRS 439.279 is hereby amended to read as follows: 38 439.279 1. The [Division] Department shall appoint [, with 39 the consent of the Director,] a State Public Health Dental Hygienist, 40 who may serve in the unclassified service of the State or as a 41 – 4 – - *SB44_R1* contractor for the [Division.] Department. The State Public Health 1 Dental Hygienist : [must:] 2 (a) [Be] Must be a resident of this State; 3 (b) [Hold] May, but is not required to, hold a current license to 4 practice dental hygiene issued pursuant to chapter 631 of NRS with 5 a special endorsement issued pursuant to NRS 631.287; and 6 (c) [Be] Must be appointed on the basis of his or her education, 7 training and experience and his or her interest in public health dental 8 hygiene and related programs. 9 2. The State Public Health Dental Hygienist: 10 (a) Shall work collaboratively with the State Dental Health 11 Officer in carrying out his or her duties; and 12 (b) May: 13 (1) Provide advice and make recommendations to the 14 Advisory Committee and the [Division] Department regarding 15 programs in this State for public health dental hygiene; and 16 (2) [Perform] If he or she holds a license to practice dental 17 hygiene issued pursuant to chapter 631 of NRS with a special 18 endorsement issued pursuant to NRS 631.287, perform any acts 19 authorized pursuant to NRS 631.287. 20 3. [The State Public Health Dental Hygienist shall devote all of 21 his or her time to the business of his or her office and shall not 22 pursue any other business or vocation or hold any other office of 23 profit. 24 4.] The [Division] Department may solicit and accept gifts and 25 grants to pay the costs associated with the position of State Public 26 Health Dental Hygienist. 27 Sec. 3. NRS 439.2791 is hereby amended to read as follows: 28 439.2791 There is hereby established within the [Division] 29 Department the State Program for Oral Health to increase public 30 knowledge and raise public awareness of the importance of oral 31 health and to educate the residents of this State on matters relating 32 to oral health, including, without limitation: 33 1. Proper oral hygiene; 34 2. The factors that increase the risk of a person developing oral 35 diseases; and 36 3. The prevention and treatment of oral diseases. 37 Sec. 4. NRS 439.2792 is hereby amended to read as follows: 38 439.2792 1. There is hereby created within the [Division of 39 Public and Behavioral Health] Department the Advisory Committee 40 on the State Program for Oral Health to advise and make 41 recommendations to the [Division] Department concerning the 42 Program. 43 – 5 – - *SB44_R1* 2. The [Administrator] Director shall appoint to the Advisory 1 Committee 13 members, including, without limitation, one or more 2 persons who are representatives of: 3 (a) Public health care professionals and educators; 4 (b) Providers of oral health care; 5 (c) Persons knowledgeable in promoting and educating the 6 public on oral health issues; and 7 (d) National dental and other oral health organizations and their 8 local or state chapters. 9 3. After the initial terms, the members of the Advisory 10 Committee serve terms of 2 years commencing on July 1. A 11 member may be reappointed. 12 4. Members of the Advisory Committee serve without 13 compensation, except that each member is entitled, while engaged in 14 the business of the Advisory Committee, to the per diem allowance 15 and travel expenses provided for state officers and employees 16 generally. 17 5. Any member of the Advisory Committee who is a public 18 employee must be granted administrative leave from his or her 19 duties to engage in the business of the Advisory Committee without 20 loss of his or her regular compensation. Such leave does not reduce 21 the amount of the member’s other accrued leave. 22 6. A majority of the members of the Advisory Committee 23 constitutes a quorum for the transaction of business, and a majority 24 of a quorum present at any meeting is sufficient for any official 25 action taken by the Advisory Committee. 26 7. The Advisory Committee shall: 27 (a) At its first meeting and annually thereafter, elect a Chair 28 from among its members; 29 (b) Meet at the call of the Director, the Chair or a majority of its 30 members as necessary and within the budget of the Advisory 31 Committee; and 32 (c) On or before July 1 of each year, submit a written report to 33 the [Administrator] Director summarizing the activities of the 34 Advisory Committee and any recommendations of the Advisory 35 Committee. 36 Sec. 5. NRS 439.2793 is hereby amended to read as follows: 37 439.2793 To carry out the provisions of NRS 439.271 to 38 439.2794, inclusive, the [Division] Department shall, with advice 39 and recommendations of the Advisory Committee: 40 1. Establish a solid scientific database of the most current 41 information on the importance of oral health, using information 42 obtained through surveillance, epidemiology and research related to 43 oral health; 44 – 6 – - *SB44_R1* 2. Provide educational materials and information on research 1 concerning matters relating to oral health to health care 2 professionals, providers of oral health care and the public, including, 3 without limitation, materials and information concerning programs 4 and services available to the public and strategies for the prevention 5 of oral diseases; 6 3. Coordinate the establishment of regional coalitions to 7 support the efforts of the Program; 8 4. Increase public awareness about the prevention, detection 9 and treatment of oral diseases among state and local governmental 10 officials who are responsible for matters relating to oral health, 11 health care professionals, providers of oral health care and 12 policymakers; 13 5. Coordinate state and local programs and services to ensure 14 that the public has adequate access to dental services; 15 6. Work with other governmental agencies, national health 16 organizations and their local and state chapters, community and 17 business leaders, community organizations and providers of oral 18 health care to: 19 (a) Coordinate the work of the Program with the work of those 20 agencies, organizations and persons; and 21 (b) Maximize the resources of state and local governments in the 22 efforts to educate the public about the importance of oral health, 23 including, without limitation, the prevention and detection of oral 24 diseases and proper oral hygiene; 25 7. Develop and carry out public awareness and media 26 campaigns in each county, targeting groups of persons who are 27 considered at risk for developing oral diseases; 28 8. Evaluate the need to improve the quality and accessibility of 29 dental services that exist in communities in this State; and 30 9. Develop and coordinate, in cooperation with the Department 31 of Education, recommendations for dental programs to encourage 32 proper oral hygiene by children. 33 Sec. 6. NRS 439.2794 is hereby amended to read as follows: 34 439.2794 1. The [Division] Department may: 35 (a) Enter into contracts for any services necessary to carry out or 36 assist the [Division] Department in carrying out the provisions of 37 NRS 439.271 to 439.2794, inclusive, with public or private entities 38 that have the appropriate expertise to provide such services; 39 (b) Apply for and accept any gift, donation, bequest, grant or 40 other source of money to carry out the provisions of NRS 439.271 41 to 439.2794, inclusive; 42 (c) Apply for any waiver from the Federal Government that may 43 be necessary to maximize the amount of money this State may 44 – 7 – - *SB44_R1* obtain from the Federal Government to carry out the provisions of 1 NRS 439.271 to 439.2794, inclusive; and 2 (d) Adopt regulations as necessary to carry out and administer 3 the Program. 4 2. Any money that is accepted by the [Division] Department 5 pursuant to subsection 1 must be deposited in the State Treasury and 6 accounted for separately in the State General Fund. 7 3. The [Administrator] Director shall administer the account 8 created pursuant to subsection 2. Money in the account does not 9 lapse to the State General Fund at the end of the fiscal year. The 10 interest and income earned on the money in the account must be 11 credited to the account. Any claims against the account must be paid 12 as other claims against the State are paid. 13 Sec. 7. The Legislative Counsel shall: 14 1. In preparing the reprint and supplements to the Nevada 15 Revised Statutes, appropriately change any references to an officer, 16 agency or other entity whose name is changed or whose 17 responsibilities are transferred pursuant to the provisions of this act 18 to refer to the appropriate officer, agency or other entity. 19 2. In preparing supplements to the Nevada Administrative 20 Code, appropriately change any references to an officer, agency or 21 other entity whose name is changed or whose responsibilities are 22 transferred pursuant to the provisions of this act to refer to the 23 appropriate officer, agency or other entity. 24 Sec. 8. 1. Any administrative regulations adopted by an 25 officer or an agency whose name has been changed or whose 26 responsibilities have been transferred pursuant to the provisions of 27 this act to another officer or agency remain in force until amended 28 by the officer or agency to which the responsibility for the adoption 29 of the regulations has been transferred. 30 2. Any contracts or other agreements entered into by an officer 31 or agency whose name has been changed or whose responsibilities 32 have been transferred pursuant to the provisions of this act to 33 another officer or agency are binding upon the officer or agency to 34 which the responsibility for the administration of the provisions of 35 the contract or other agreement has been transferred. Such contracts 36 and other agreements may be enforced by the officer or agency to 37 which the responsibility for the enforcement of the provisions of the 38 contract or other agreement has been transferred. 39 3. Any action taken by an officer or agency whose name has 40 been changed or whose responsibilities have been transferred 41 pursuant to the provisions of this act to another officer or agency 42 remains in effect as if taken by the officer or agency to which the 43 responsibility for the enforcement of such actions has been 44 transferred. 45 – 8 – - *SB44_R1* Sec. 9. This act becomes effective on July 1, 2023. 1 H