By: Kolkhorst H.B. No. 3201
A BILL TO BE ENTITLED
AN ACT
relating to the practice of dentistry.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 254.004, Occupations Code, is amended to
by adding subsections (c) and (d) read as follows:
(c) The board shall collect an additional $80 surcharge for
each of the following fees:
(1) first registration permit; and
(2) renewal of a registration permit.
(d) The board shall deposit each surcharge collected to the
credit of the public assurance account. The public assurance
account is an account in the general revenue fund that shall be
appropriated only to the board to pay for the board's enforcement
program, including the expert dentist panel.
SECTION 2. Section 254.006, Occupations Code, is amended to
read as follows:
(b) Investigation files and other records are confidential.
and shall be divulged only to the persons investigated at the
completion of the investigation. Notwithstanding this provision
tThe board:
(1) must provide notice under section 263.0076; and
(2) may share investigation files and other records
with another state regulatory agency or a local, state, or federal
law enforcement agency.
SECTION 3. Subtitle D, Chapter 254, Occupations Code, is
amended by adding Section 254.019 to read as follows:
Section 254.019 DELEGATION OF CERTAIN ACTIONS
(a) The board may delegate authority to board employees to
issue licenses under this subtitle to applicants who clearly meet
all licensing requirements. If the board employees determine that
the applicant does not clearly meet all licensing requirements, the
application shall be returned to the board. A license issued under
this subsection does not require formal board approval.
(b) The board may delegate to a committee of board employees
the authority to dismiss or enter into an agreed settlement of a
complaint that does not relate directly to patient care or that
involves only administrative violations. The disposition
determined by the committee must be approved by the board at a
public meeting. A complaint delegated under this section shall be
referred for informal proceedings under Section 263.0075 if:
(1) the committee of employees determines that the
complaint should not be dismissed or settled;
(2) the committee is unable to reach an agreed
settlement; or
(3) the affected licensee requests that the complaint
be referred for informal proceedings.
SECTION 4. Section 255.006, Occupations Code, is amended by
amending Subsections (a) and (d-1) to read as follows:
(a) A complaint received under this chapter must be filed
with and reviewed by the board to determine jurisdiction. If the
board has jurisdiction, the board shall investigate the complaint
to determine the facts concerning the complaint. the board shall
complete a preliminary investigation of the complaint not later
than the 45th day after the date of receiving the complaint. The
board shall first determine whether the licensee constitutes a
continuing threat to the public welfare. On completion of the
preliminary investigation, the board shall determine whether to
officially proceed on the complaint. If the board fails to complete
the preliminary investigation in the time required by this
subsection, the board's official investigation of the complaint is
considered to commence on that date.
(b) The board may not consider a complaint that is filed
with the board after the fourth anniversary of the date:
(1) the act that is the basis of the complaint
occurred; or
(2) the complainant discovered, or in the exercise of
reasonable diligence should have discovered, the occurrence of the
act that is the basis of the complaint.
(c) The board by rule shall:
(1) adopt a form to standardize information concerning
complaints filed with the board; and
(2) prescribe information to be provided to a person
when the person files a complaint with the board.
(d) The board shall adopt rules concerning the
investigation of a complaint filed with the board. The rules
adopted under this subsection must:
(1) distinguish between categories of complaints;
(2) ensure that a complaint is not dismissed without
appropriate consideration;
(3) require that the board be advised of a complaint
that is dismissed and that a letter be sent to the person who filed
the complaint explaining the action taken on the dismissed
complaint;
(4) ensure that the person who filed the complaint has
an opportunity to explain the allegations made in the complaint;
(5) require that investigators used by the board be
state employees; and
(6) establish procedures by which a board employee may
dismiss a complaint if the investigation does not reveal a
violation.
(7) Expired.
(d-1) Procedures established under Subsection (d)(6) must:
(1) require a board employee to consult with a dentist
member of the board before dismissing a complaint relating to
patient morbidity, professional conduct, or quality of care;
(12) ensure that the decision to dismiss a complaint
is made with the appropriate level of review and necessary
expertise and experience; and
(23) require the dismissal of a complaint to be
reported to the board at a public meeting of the board.
(d-2) Repealed by Acts 2005, 79th Leg., Ch. 810, Sec. 10,
eff. September 1, 2005.
(e) The board shall:
(1) dispose of each complaint in a timely manner; and
(2) establish a schedule for conducting each phase of
a complaint that is under the control of the board.
SECTION 5. Subtitle D, Chapter 255, Occupations Code, is
amended by adding Section 255.0065 to read as follows:
Section 255.0065 EXPERTS. (a) The board by rule shall provide
for an expert dentist panel appointed by the board to assist with
complaints and investigations relating to medical competency by
acting as expert dentist reviewers. Each member of the expert
dentist panel must be licensed to practice dentistry in this state.
The rules adopted under this subsection must include provisions
governing the composition of the panel, qualifications for
membership on the panel, length of time a member may serve on the
panel, grounds for removal from the panel, the avoidance of
conflicts of interest, including situations in which the affected
dentist and the panel member live or work in the same geographical
area or are competitors, and the duties to be performed by the
panel. The board's rules governing grounds for removal from the
panel must include providing for the removal of a panel member who
is repeatedly delinquent in reviewing complaints and in submitting
reports to the board.
(b) If the initial review under 255.006(a) indicates that an
act by a licensee falls below an acceptable standard of care, the
complaint shall be reviewed by an expert panel authorized under (a)
consisting of dentists who practice in the same specialty as the
dentist who is the subject of the complaint or in another specialty
that is similar to the dentist's specialty.
(c) The expert dentist panel shall report in writing the
panel's determinations based on the review of the complaint under
Subsection (b). The report must specify the standard of care that
applies to the facts that are the basis of the complaint and the
clinical basis for the panel's determinations, including any
reliance on peer-reviewed journals, studies, or reports.
(d) A dentist on the expert dentist panel authorized by
Section 154.056(e) who is initially selected to review a complaint
shall:
(1) determine whether the dentist who is the subject
of the complaint has violated the standard of care applicable to the
circumstances; and
(2) issue a preliminary written report of that
determination.
(e) A second expert dentist reviewer shall review the first
dentist's preliminary report and other information associated with
the complaint. If the second expert dentist agrees with the first
expert dentist, the first dentist shall issue a final written
report on the matter.
(f) If the second expert dentist does not agree with the
conclusions of the first expert dentist, a third expert dentist
reviewer shall review the preliminary report and information and
decide between the conclusions reached by the first two expert
dentists. The final written report shall be issued by the third
dentist or the dentist with whom the third dentist concurs.
(g) In reviewing a complaint, the expert dentist reviewers
assigned to examine the complaint may consult and communicate with
each other about the complaint in formulating their opinions and
reports.
SECTION 6. Subtitle D, Chapter 263, Occupations Code, is
amended by adding Section 263.0076 to read as follows:
Section 263.0076 INFORMAL SETTLEMENT CONFERENCE NOTICE.
(a) If an informal meeting will be held under 263.0075, notice of
the time and place of the informal meeting must be given to the
license holder not later than the 45th day before the date the
informal meeting is held.
(b) The notice required by Subsection (a) must be
accompanied by a written statement of the nature of the allegations
against the license holder and the information the board intends to
use at the informal meeting. If the board does not provide the
statement or information when the notice is provided, the license
holder may use that failure as grounds for rescheduling the
informal meeting. The license holder must provide to the board the
license holder's rebuttal not later than the 15th day before the
date of the meeting in order for that information to be considered
at the meeting.
(c) On request by a license holder under review, the board
shall make a recording of the informal meeting. The recording is a
part of the investigative file and may not be released to a third
party unless authorized under this subtitle. The board may charge
the license holder a fee to cover the cost of recording the meeting.
The board shall provide a copy of the recording to the license
holder on the license holder's request.
SECTION 7. Subtitle D, Chapter 263, Occupations Code, is
amended by adding Section 263.0077 to read as follows:
Sec. 263.0077 REMEDIAL PLAN. (a) The board may issue and
establish the terms of a remedial plan to resolve the investigation
of a complaint relating to this subtitle.
(b) A remedial plan may not contain a provision that:
(1) revokes, suspends, limits, or restricts a person's
license or other authorization to practice dentistry; or
(2) assesses an administrative penalty against a
person.
(c) A remedial plan may not be imposed to resolve a
complaint:
(1) concerning:
(A) a patient death;
(B) the commission of a felony; or
(C) a matter in which the dentist engaged in
inappropriate sexual behavior or contact with a patient or became
financially or personally involved with a patient in an
inappropriate manner; or
(2) in which the appropriate resolution may involve a
restriction on the manner in which a license holder practices
dentistry.
(d) The board may not issue a remedial plan to resolve a
complaint against a license holder if the license holder has
previously entered into a remedial plan with the board for the
resolution of a different complaint relating to this subtitle.
(e) The board may assess a fee against a license holder
participating in a remedial plan in an amount necessary to recover
the costs of administering this plan.
(f) A remedial plan is public information.
(g) In civil litigation, a remedial plan is a settlement
agreement under Rule 408, Texas Rules of Evidence.
(h) The board shall adopt rules necessary to implement this
section.