Texas 2009 - 81st Regular

Texas Senate Bill SB455 Compare Versions

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1	1	S.B. No. 455
2	2
3	3
4	4	AN ACT
5	5	relating to the regulation of the practice of dental assistants,
6	6	including the delegation of certain dental acts.
7	7	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	8	SECTION 1. Subsection (a), Section 258.002, Occupations
9	9	Code, is amended to read as follows:
10	10	(a) A licensed dentist may delegate to a qualified and
11	11	trained dental assistant acting under the dentist's general or
12	12	direct supervision any dental act that a reasonable and prudent
13	13	dentist would find is within the scope of sound dental judgment to
14	14	delegate if:
15	15	(1) in the opinion of the delegating dentist, the act:
16	16	(A) can be properly and safely performed by the
17	17	person to whom the dental act is delegated; and
18	18	(B) is performed in a customary manner and is not
19	19	in violation of this subtitle or any other statute; [and]
20	20	(2) the person to whom the dental act is delegated does
21	21	not represent to the public that the person is authorized to
22	22	practice dentistry; and
23	23	(3) the person to whom the dental act is delegated
24	24	holds the appropriate certificate, if a certificate is required to
25	25	perform the act.
26	26	SECTION 2. Chapter 265, Occupations Code, is amended by
27	27	adding Section 265.0001 to read as follows:
28	28	Sec. 265.0001. DEFINITIONS. In this chapter:
29	29	(1) "Coronal polishing" means the removal of plaque
30	30	and extrinsic stain from exposed natural and restored tooth
31	31	surfaces using an appropriate rotary instrument with rubber cup or
32	32	brush and polishing agent, including the use of a toothbrush.
33	33	(2) "Interim treatment of a minor emergency dental
34	34	condition" means treatment of a condition that:
35	35	(A) arises unexpectedly;
36	36	(B) causes pain or discomfort to the patient;
37	37	(C) is considered reversible;
38	38	(D) does not require cutting hard or soft tissue;
39	39	and
40	40	(E) in the opinion of the treating dentist, may
41	41	be performed by a properly trained dental assistant.
42	42	SECTION 3. Section 265.002, Occupations Code, is amended to
43	43	read as follows:
44	44	Sec. 265.002. SUPERVISION, DIRECTION, AND RESPONSIBILITY.
45	45	(a) In this subtitle, a dental assistant is under the direct
46	46	supervision, direction, and responsibility of a dentist if the
47	47	dentist:
48	48	(1) employs the dental assistant or is in charge of the
49	49	dental assistant; and
50	50	(2) is physically present in the dental office when
51	51	the dental assistant performs a delegated dental act.
52	52	(b) For purposes of Subsection (a)(2), physical presence
53	53	does not require that the supervising dentist be in the treatment
54	54	room when the dental assistant performs the service as long as the
55	55	dentist is in the dental office.
56	56	(c) In this subtitle, a dental assistant is under the
57	57	general supervision, direction, and responsibility of a dentist if
58	58	the dentist:
59	59	(1) employs the dental assistant or is in charge of the
60	60	dental assistant; and
61	61	(2) is responsible for supervising the services to be
62	62	performed by the dental assistant.
63	63	SECTION 4. Section 265.003, Occupations Code, is amended to
64	64	read as follows:
65	65	Sec. 265.003. PERMITTED DUTIES. (a) A dental assistant
66	66	who is not professionally licensed may[:
67	67	[(1)] be employed by and work in the office of a
68	68	licensed and practicing dentist[;] and
69	69	[(2)] perform one or more delegated dental acts under:
70	70	(1) the direct supervision, direction, and
71	71	responsibility of the dentist, including:
72	72	(A) the application of a pit and fissure sealant;
73	73	(B) coronal polishing, if the dental assistant
74	74	holds a certificate under Section 265.006; and
75	75	(C) the application of fluoride varnish; or
76	76	(2) the general supervision, direction, and
77	77	responsibility of the dentist, limited to:
78	78	(A) the making of dental x-rays in compliance
79	79	with Section 265.005; and
80	80	(B) the provision of interim treatment of a minor
81	81	emergency dental condition to an existing patient of the treating
82	82	dentist.
83	83	(a-1) A treating dentist who delegates the provision of
84	84	interim treatment of a minor emergency dental condition to a dental
85	85	assistant under Subsection (a)(2)(B) shall:
86	86	(1) delegate the procedure orally or in writing before
87	87	the dental assistant performs the procedure;
88	88	(2) retain responsibility for the procedure; and
89	89	(3) schedule a follow-up appointment with the patient
90	90	within a reasonable time.
91	91	(b) A dental assistant who applies [may apply] a pit and
92	92	fissure sealant under Subsection (a) may cleanse the occlusal and
93	93	smooth surfaces of the teeth immediately before and for the sole
94	94	purpose of preparing the tooth area for the placement of the pit and
95	95	fissure sealant or orthodontic bonding resin. A procedure
96	96	performed by a dental assistant under this subsection may not be
97	97	billed as a prophylaxis [only if:
98	98	[(1) the assistant is certified to apply a pit and
99	99	fissure sealant under Section 265.004; and
100	100	[(2) the dentist described by Subsection (a):
101	101	[(A) is a Medicaid provider; or
102	102	[(B) practices in an area determined to be
103	103	underserved by the Texas Department of Health].
104	104	SECTION 5. Subsection (b), Section 265.004, Occupations
105	105	Code, is amended to read as follows:
106	106	(b) To qualify for a certificate, an applicant must:
107	107	(1) have at least two years' experience as a dental
108	108	assistant; and
109	109	(2) have successfully completed a minimum of eight
110	110	[16] hours of clinical and didactic education in pit and fissure
111	111	sealants taken through an accredited dental hygiene program or a
112	112	dental assisting program accredited by the Commission on Dental
113	113	Accreditation of the American Dental Association and approved by
114	114	the board.
115	115	SECTION 6. Chapter 265, Occupations Code, is amended by
116	116	adding Section 265.006 to read as follows:
117	117	Sec. 265.006. CORONAL POLISHING CERTIFICATE. (a) The
118	118	board shall issue a coronal polishing certificate to a dental
119	119	assistant who qualifies under this section.
120	120	(b) To qualify for a coronal polishing certificate, an
121	121	applicant must have at least two years' experience as a dental
122	122	assistant and:
123	123	(1) have successfully completed at least eight hours
124	124	of clinical and didactic education in coronal polishing taken
125	125	through a dental assisting program accredited by the Commission on
126	126	Dental Accreditation of the American Dental Association and
127	127	approved by the board that includes courses on:
128	128	(A) oral anatomy and tooth morphology relating to
129	129	retention of plaque and stain;
130	130	(B) indications, contraindications, and
131	131	complications of coronal polishing;
132	132	(C) principles of coronal polishing, including
133	133	armamentarium, operator and patient positioning, technique, and
134	134	polishing agents;
135	135	(D) infection control procedures;
136	136	(E) polishing coronal surfaces of teeth; and
137	137	(F) jurisprudence relating to coronal polishing;
138	138	or
139	139	(2) present proof to the board that the assistant has:
140	140	(A) graduated from a dental assisting program
141	141	accredited by the Commission on Dental Accreditation of the
142	142	American Dental Association and approved by the board that includes
143	143	specific didactic course work and clinical training in coronal
144	144	polishing; or
145	145	(B) received certification of completion of
146	146	requirements specified by the Dental Assisting National Board and
147	147	approved by the board.
148	148	SECTION 7. Chapter 265, Occupations Code, is amended by
149	149	adding Section 265.007 to read as follows:
150	150	Sec. 265.007. CONTINUING EDUCATION FOR CERTIFICATE
151	151	HOLDERS. (a) To renew a certificate issued under this chapter, a
152	152	dental assistant must complete six hours of continuing education
153	153	each year in areas covering dental assistant duties.
154	154	(b) A dental assistant holding two or more certificates
155	155	authorized by this chapter is required to complete 12 hours of
156	156	continuing education each year to renew all of the certificates
157	157	held by the assistant.
158	158	(c) A dental assistant may fulfill continuing education
159	159	requirements through board-approved self-study, interactive
160	160	computer courses, or lecture courses.
161	161	SECTION 8. The following provisions of the Occupations Code
162	162	are repealed:
163	163	(1) Subsection (b), Section 258.002;
164	164	(2) Subsection (d), Section 265.004; and
165	165	(3) Subsections (j) and (k), Section 265.005.
166	166	SECTION 9. The change in law made by this Act to Subsection
167	167	(b), Section 265.004, Occupations Code, applies only to an
168	168	application for a pit and fissure sealant certificate under that
169	169	section that is filed on or after the effective date of this Act. An
170	170	application filed before that date is governed by the law in effect
171	171	on the date the application was filed, and the former law is
172	172	continued in effect for that purpose.
173	173	SECTION 10. The change in law made by this Act by the
174	174	enactment of Section 265.007, Occupations Code, applies to a
175	175	certificate issued under Chapter 265, Occupations Code, that
176	176	expires on or after the effective date of this Act. A holder of a
177	177	certificate issued under that chapter that expires before the
178	178	effective date of this Act may renew that certificate by complying
179	179	with the law in effect at the time the certificate was issued, and
180	180	the former law is continued in effect for that purpose.
181	181	SECTION 11. This Act takes effect September 1, 2009.
182	182	______________________________ ______________________________
183	183	President of the Senate Speaker of the House
184	184	I hereby certify that S.B. No. 455 passed the Senate on
185	185	April 30, 2009, by the following vote: Yeas 31, Nays 0.
186	186	______________________________
187	187	Secretary of the Senate
188	188	I hereby certify that S.B. No. 455 passed the House on
189	189	May 25, 2009, by the following vote: Yeas 142, Nays 0, one
190	190	present not voting.
191	191	______________________________
192	192	Chief Clerk of the House
193	193	Approved:
194	194	______________________________
195	195	Date
196	196	______________________________
197	197	Governor