Texas 2017 - 85th Regular

Texas House Bill HB2990 Compare Versions

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

Old	New	Differences
1	1	85R2773 TSR-D
2	2	By: Burkett H.B. No. 2990
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the continuation and functions of the State Board of
8	8	Dental Examiners; imposing fees.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 251.005, Occupations Code, is amended to
11	11	read as follows:
12	12	Sec. 251.005. APPLICATION OF SUNSET ACT. The State Board
13	13	of Dental Examiners is subject to Chapter 325, Government Code
14	14	(Texas Sunset Act). Unless continued in existence as provided by
15	15	that chapter, the board is abolished September 1, 2029 [2017].
16	16	SECTION 2. Section 252.001(a), Occupations Code, is amended
17	17	to read as follows:
18	18	(a) The State Board of Dental Examiners consists of 11 [15]
19	19	members appointed by the governor with the advice and consent of the
20	20	senate as follows:
21	21	(1) six [eight] reputable dentist members who reside
22	22	in this state and have been actively engaged in the practice of
23	23	dentistry for at least the five years preceding appointment;
24	24	(2) three [two] reputable dental hygienist members who
25	25	reside in this state and have been actively engaged in the practice
26	26	of dental hygiene for at least the five years preceding
27	27	appointment; and
28	28	(3) two [five] members who represent the public.
29	29	SECTION 3. Section 252.003, Occupations Code, is amended to
30	30	read as follows:
31	31	Sec. 252.003. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. (a)
32	32	In this section, "Texas trade association" means a [nonprofit,]
33	33	cooperative[,] and voluntarily joined statewide association of
34	34	business or professional competitors in this state designed to
35	35	assist its members and its industry or profession in dealing with
36	36	mutual business or professional problems and in promoting their
37	37	common interest.
38	38	(b) A person may not be a member of the board and may not be a
39	39	board employee employed in a "bona fide executive, administrative,
40	40	or professional capacity," as that phrase is used for purposes of
41	41	establishing an exemption to the overtime provisions of the federal
42	42	Fair Labor Standards Act of 1938 (29 U.S.C. Section 201 et seq.) if:
43	43	(1) the person is an [An] officer, employee, or paid
44	44	consultant of a Texas trade association in the field of health care;
45	45	or
46	46	(2) the person's [may not be a member or employee of
47	47	the board who is exempt from the state's position classification
48	48	plan or is compensated at or above the amount prescribed by the
49	49	General Appropriations Act for B9 of the position classification
50	50	salary schedule.
51	51	[(c) A person who is the] spouse is [of] an officer,
52	52	manager, or paid consultant of a Texas trade association in the
53	53	field of health care [may not be a board member and may not be a
54	54	board employee who is exempt from the state's position
55	55	classification plan or is compensated at or above the amount
56	56	prescribed by the General Appropriations Act for B9 of the position
57	57	classification salary schedule].
58	58	(c) [(d)] A person may not serve as a member of the board or
59	59	act as the general counsel to the board if the person is required to
60	60	register as a lobbyist under Chapter 305, Government Code, because
61	61	of the person's activities for compensation on behalf of a
62	62	profession related to the operation of the board.
63	63	SECTION 4. Section 252.010, Occupations Code, is amended by
64	64	amending Subsection (b) and adding Subsection (d) to read as
65	65	follows:
66	66	(b) The training program must provide the person with
67	67	information regarding:
68	68	(1) the law governing board operations [this
69	69	subtitle];
70	70	(2) the programs, [operated by the board;
71	71	[(3) the role and] functions, [of the board;
72	72	[(4) the] rules, and [of the board, with an emphasis on
73	73	the rules that relate to disciplinary and investigatory authority;
74	74	[(5) the current] budget of [for] the board;
75	75	(3) the scope of and limitations on the rulemaking
76	76	authority of the board;
77	77	(4) [(6)] the results of the most recent formal audit
78	78	of the board;
79	79	(5) [(7)] the requirements of:
80	80	(A) laws relating to [the] open meetings [law],
81	81	[Chapter 551, Government Code;
82	82	[(B) the] public information [law], [Chapter
83	83	552, Government Code;
84	84	[(C) the] administrative procedure [law],
85	85	[Chapter 2001, Government Code;] and disclosing conflicts
86	86	[(D) other laws relating to public officials,
87	87	including conflict] of interest [laws]; and
88	88	(B) other laws applicable to members of the board
89	89	in performing their duties; and
90	90	(6) [(8)] any applicable ethics policies adopted by
91	91	the board or the Texas Ethics Commission.
92	92	(d) The executive director shall create a training manual
93	93	that includes the information required by Subsection (b). The
94	94	executive director shall distribute a copy of the training manual
95	95	annually to each board member. On receipt of the training manual,
96	96	each board member shall sign and submit to the executive director a
97	97	statement acknowledging receipt of the training manual.
98	98	SECTION 5. Chapter 254, Occupations Code, is amended by
99	99	adding Section 254.0065 to read as follows:
100	100	Sec. 254.0065. CONFIDENTIALITY OF CERTAIN INFORMATION
101	101	REGARDING LICENSE HOLDER. (a) Except as provided by Subsection
102	102	(b), all information, records, and proceedings of the board or an
103	103	authorized agent of the board relating to the participation of a
104	104	license holder in a peer assistance program or the evaluation of a
105	105	license holder under Section 263.0025 are confidential and not
106	106	subject to disclosure under Chapter 552, Government Code.
107	107	(b) The board may disclose a disciplinary action taken
108	108	against a license holder in the enforcement of Section
109	109	263.002(a)(1), (7), or (11). The board may not disclose the nature
110	110	of the impairment or condition that resulted in the board's action.
111	111	SECTION 6. Section 254.010(b), Occupations Code, is amended
112	112	to read as follows:
113	113	(b) Rules adopted under this section must include
114	114	procedures to:
115	115	(1) monitor for compliance a license holder who is
116	116	ordered by the board to perform a certain act; [and]
117	117	(2) identify and monitor each license holder who
118	118	represents a risk to the public; and
119	119	(3) periodically review reports filed with the
120	120	National Practitioner Data Bank for any report of disciplinary
121	121	action taken against a license holder by another state that would
122	122	constitute grounds for disciplinary action under Section 263.002.
123	123	SECTION 7. Chapter 254, Occupations Code, is amended by
124	124	adding Section 254.0105 to read as follows:
125	125	Sec. 254.0105. MONITORING HARMFUL PRESCRIBING PATTERNS.
126	126	(a) The board shall periodically check the prescribing information
127	127	submitted to the Texas State Board of Pharmacy as authorized by
128	128	Section 481.076(a)(1), Health and Safety Code, to determine whether
129	129	a dentist licensed under this subtitle is engaging in potentially
130	130	harmful prescribing patterns or practices.
131	131	(b) The board, in coordination with the Texas State Board of
132	132	Pharmacy, shall determine the conduct that constitutes a
133	133	potentially harmful prescribing pattern or practice for purposes of
134	134	Subsection (a). In determining the conduct that constitutes a
135	135	potentially harmful prescribing pattern or practice, the board
136	136	shall consider:
137	137	(1) the number of times a dentist licensed under this
138	138	subtitle prescribes a drug listed in Section 258.0535(b); and
139	139	(2) for prescriptions described by Subdivision (1),
140	140	patterns of prescribing combinations of those drugs and other
141	141	dangerous combinations of drugs identified by the board.
142	142	(c) If the board suspects that a dentist licensed under this
143	143	subtitle may be engaging in potentially harmful prescribing
144	144	patterns or practices, the board may notify the dentist of the
145	145	potentially harmful prescribing pattern or practice.
146	146	(d) The board may initiate a complaint against a dentist
147	147	based on information obtained under this section.
148	148	SECTION 8. Section 256.002(a), Occupations Code, is amended
149	149	to read as follows:
150	150	(a) An applicant for a license to practice dentistry must:
151	151	(1) be at least 21 years of age; and
152	152	(2) [be of good moral character; and
153	153	[(3)] present proof of:
154	154	(A) graduation from a dental school accredited by
155	155	the Commission on Dental Accreditation of the American Dental
156	156	Association; or
157	157	(B) graduation from a dental school that is not
158	158	accredited by the commission and successful completion of training
159	159	in an American Dental Association approved specialty in an
160	160	education program accredited by the commission that consists of at
161	161	least two years of training as specified by the Council on Dental
162	162	Education.
163	163	SECTION 9. Section 256.053, Occupations Code, is amended to
164	164	read as follows:
165	165	Sec. 256.053. ELIGIBILITY FOR LICENSE. (a) An applicant
166	166	for a license to practice dental hygiene in this state must be:
167	167	(1) at least 18 years of age;
168	168	(2) [of good moral character;
169	169	[(3)] a graduate of an accredited high school or hold a
170	170	certificate of high school equivalency; and
171	171	(3) [(4)] a graduate of a recognized school of
172	172	dentistry or dental hygiene accredited by the Commission on Dental
173	173	Accreditation of the American Dental Association and approved by
174	174	the board or an alternative dental hygiene training program.
175	175	(b) A school of dentistry or dental hygiene described by
176	176	Subsection (a)(3) [(a)(4)] must include at least two full academic
177	177	years of instruction or its equivalent at the postsecondary level.
178	178	SECTION 10. Chapter 257, Occupations Code, is amended by
179	179	adding Section 257.003 to read as follows:
180	180	Sec. 257.003. REFUSAL FOR VIOLATION OF BOARD ORDER. The
181	181	board may refuse to renew a license issued under this subtitle if
182	182	the license holder is in violation of a board order.
183	183	SECTION 11. Section 258.002(a), Occupations Code, is
184	184	amended to read as follows:
185	185	(a) A licensed dentist may delegate to a qualified and
186	186	trained dental assistant acting under the dentist's general or
187	187	direct supervision any dental act that a reasonable and prudent
188	188	dentist would find is within the scope of sound dental judgment to
189	189	delegate if:
190	190	(1) in the opinion of the delegating dentist, the act:
191	191	(A) can be properly and safely performed by the
192	192	person to whom the dental act is delegated; and
193	193	(B) is performed in a customary manner and is not
194	194	in violation of this subtitle or any other statute;
195	195	(2) the person to whom the dental act is delegated does
196	196	not represent to the public that the person is authorized to
197	197	practice dentistry; and
198	198	(3) the person to whom the dental act is delegated is
199	199	registered under Chapter 265 [holds the appropriate certificate],
200	200	if registration [a certificate] is required to perform the act.
201	201	SECTION 12. Subchapter B, Chapter 258, Occupations Code, is
202	202	amended by adding Section 258.0535 to read as follows:
203	203	Sec. 258.0535. DUTIES RELATED TO CERTAIN PRESCRIPTIONS.
204	204	(a) A dentist may not prescribe a drug listed in Subsection (b) to a
205	205	patient unless the dentist has reviewed the patient's prescription
206	206	history by accessing the prescription information submitted to the
207	207	Texas State Board of Pharmacy as authorized by Section
208	208	481.076(a)(5), Health and Safety Code.
209	209	(b) Subsection (a) applies only to the prescribing of:
210	210	(1) opioids;
211	211	(2) benzodiazepines;
212	212	(3) barbiturates; or
213	213	(4) carisoprodol.
214	214	(c) Failure by a dentist to comply with the requirements of
215	215	this section is grounds for disciplinary action under Section
216	216	263.002.
217	217	SECTION 13. Section 258.054(c), Occupations Code, is
218	218	amended to read as follows:
219	219	(c) A dentist may not authorize a dental assistant to make a
220	220	dental x-ray unless the dental assistant is registered [holds an
221	221	x-ray certificate issued] under Chapter 265 [Section 265.005].
222	222	SECTION 14. The heading to Subchapter D, Chapter 258,
223	223	Occupations Code, is amended to read as follows:
224	224	SUBCHAPTER D. [ENTERAL] ADMINISTRATION OF ANESTHESIA
225	225	SECTION 15. Section 258.151, Occupations Code, is amended
226	226	to read as follows:
227	227	Sec. 258.151. DEFINITIONS [DEFINITION]. In this
228	228	subchapter:
229	229	(1) "High-risk patient" means a patient who:
230	230	(A) is older than 75 years of age; or
231	231	(B) has a level 3 or 4 classification according
232	232	to the American Society of Anesthesiologists Physical Status
233	233	Classification System.
234	234	(2) "Pediatric patient" means a patient 12 years of
235	235	age or younger[, "enteral" means any technique of administering
236	236	anesthesia in which the anesthetic is absorbed through the
237	237	gastrointestinal tract or oral mucosa. Examples of enterally
238	238	administering anesthesia include administering an anesthetic
239	239	orally, rectally, sublingually, or intranasally].
240	240	SECTION 16. Subchapter D, Chapter 258, Occupations Code, is
241	241	amended by adding Section 258.1521 to read as follows:
242	242	Sec. 258.1521. ADVISORY COMMITTEE ON DENTAL ANESTHESIA.
243	243	(a) The board shall establish an advisory committee to advise the
244	244	board regarding the adoption and amendment of rules related to
245	245	dental anesthesia. The advisory committee consists of nine members
246	246	appointed by the presiding officer of the board and must include:
247	247	(1) a dentist;
248	248	(2) a dentist anesthesiologist;
249	249	(3) an oral and maxillofacial surgeon;
250	250	(4) a pediatric dentist; and
251	251	(5) a physician anesthesiologist.
252	252	(b) The board shall designate an attorney employed by the
253	253	board to:
254	254	(1) act as counsel and provide legal advice to the
255	255	advisory committee; and
256	256	(2) be present during the committee's meetings and
257	257	deliberations.
258	258	(c) The advisory committee shall report to the board at
259	259	least annually regarding the committee's recommendations or other
260	260	findings related to dental anesthesia. The board shall post on the
261	261	board's Internet website any recommendations or findings reported
262	262	by the committee.
263	263	(d) A board member may not serve as a member of the advisory
264	264	committee.
265	265	(e) Chapter 2110, Government Code, does not apply to the
266	266	size, composition, or duration of the advisory committee.
267	267	SECTION 17. Sections 258.153, 258.154, and 258.155,
268	268	Occupations Code, are amended to read as follows:
269	269	Sec. 258.153. RULES. (a) The board shall adopt rules to
270	270	administer this subchapter, including rules to establish [by rule]
271	271	the minimum standards for the [enteral] administration of
272	272	anesthesia by a dentist.
273	273	(b) The rules must be designed to protect the health,
274	274	safety, and welfare of the public and must include requirements
275	275	relating to:
276	276	(1) for each level of permit held, the methods that may
277	277	be used to [enterally] administer an anesthetic and the anesthetic
278	278	agents that may be used;
279	279	(2) dental patient evaluation, diagnosis, counseling,
280	280	and preparation;
281	281	(3) dental patient monitoring to be performed and
282	282	equipment to be used during a procedure and during postprocedure
283	283	monitoring;
284	284	(4) emergency procedures, drugs, and equipment,
285	285	including education, training, and certification of personnel, as
286	286	appropriate, and including protocols for transfers to a hospital;
287	287	(5) the documentation necessary to demonstrate
288	288	compliance with this subchapter; and
289	289	(6) the period in which protocols or procedures
290	290	covered by rules of the board shall be reviewed, updated, or
291	291	amended.
292	292	Sec. 258.154. COMPLIANCE WITH ANESTHESIA RULES. (a) A [On
293	293	and after August 31, 2002, a] dentist who practices dentistry in
294	294	this state and who [enterally] administers anesthesia or performs a
295	295	procedure for which anesthesia is [enterally] administered shall
296	296	comply with the rules adopted under this subchapter.
297	297	(b) The board may require a dentist to submit and comply
298	298	with a corrective action plan to remedy or address any current or
299	299	potential deficiencies with the dentist's [enteral] administration
300	300	of anesthesia in accordance with this subtitle or rules of the
301	301	board.
302	302	Sec. 258.155. ANNUAL PERMIT REQUIRED. (a) The board shall
303	303	issue permits to administer anesthesia in the following four
304	304	categories based on the extent to which the intended procedure will
305	305	alter the patient's mental status and the method of anesthetic
306	306	delivery:
307	307	(1) level 1: minimal sedation;
308	308	(2) level 2: moderate sedation (enteral
309	309	administration);
310	310	(3) level 3: moderate sedation (parenteral
311	311	administration); and
312	312	(4) level 4: deep sedation or general anesthesia.
313	313	(b) A [Not later than September 1, 2002, the board shall
314	314	require each] dentist may not administer [who enterally
315	315	administers] anesthesia or perform [performs] a procedure for which
316	316	anesthesia is [enterally] administered unless the dentist [to]
317	317	annually obtains the appropriate [obtain a] permit issued under
318	318	this section [from the board by completing a form prescribed by the
319	319	board].
320	320	(c) The board shall set and impose a fee for issuance of a
321	321	[the] permit in an amount designed to recover the costs of
322	322	regulating a permit holder under this subchapter.
323	323	(d) [(b)] The board shall coordinate the times at which a
324	324	permit must be renewed with the times at which a dentist's license
325	325	must be renewed under Chapter 257 so that the times of registration,
326	326	payment, notice, and imposition of penalties for late payment are
327	327	similar and provide a minimum of administrative burden to the board
328	328	and to dentists.
329	329	SECTION 18. Subchapter D, Chapter 258, Occupations Code, is
330	330	amended by adding Sections 258.1551, 258.1552, 258.1553, and
331	331	258.1554 to read as follows:
332	332	Sec. 258.1551. PERMIT QUALIFICATIONS. (a) The board by
333	333	rule shall establish the qualifications to obtain each level of
334	334	permit described by Section 258.155, including the education and
335	335	training required to obtain the permit.
336	336	(b) The rules adopted under Subsection (a) must require an
337	337	applicant for a level 2, level 3, or level 4 permit to complete
338	338	training on:
339	339	(1) pre-procedural patient evaluation, including the
340	340	evaluation of a patient's airway and physical status as classified
341	341	by the American Society of Anesthesiologists;
342	342	(2) the continuous monitoring of a patient's level of
343	343	sedation during the administration of anesthesia; and
344	344	(3) the management of emergency situations.
345	345	Sec. 258.1552. PORTABILITY OF ANESTHESIA SERVICES. (a) A
346	346	dentist who holds a permit issued under this subchapter may not
347	347	provide a permitted anesthesia service in a location other than a
348	348	facility or satellite facility unless the dentist obtains
349	349	authorization from the board under this section.
350	350	(b) The board shall adopt rules establishing procedures and
351	351	other requirements for a permit holder to apply for and obtain an
352	352	authorization described by Subsection (a).
353	353	(c) Rules adopted under Subsection (b) must require an
354	354	applicant to complete advanced didactic and clinical training and
355	355	may require additional training of, or establish additional
356	356	qualifications for, an applicant who will administer anesthesia to
357	357	pediatric or high-risk patients.
358	358	Sec. 258.1553. ADMINISTRATION OF ANESTHESIA TO CERTAIN
359	359	PATIENTS. (a) A permit holder under this subchapter may not
360	360	administer anesthesia under a level 2, level 3, or level 4 permit to
361	361	a pediatric or high-risk patient unless the permit holder has:
362	362	(1) demonstrated to the satisfaction of the board that
363	363	the permit holder has advanced didactic and clinical training; and
364	364	(2) obtained authorization from the board under this
365	365	section.
366	366	(b) The board by rule may establish limitations on the
367	367	administration of anesthesia by a permit holder to a pediatric or
368	368	high-risk patient.
369	369	Sec. 258.1554. MINIMUM EMERGENCY PREPAREDNESS STANDARDS.
370	370	(a) The board shall adopt rules to establish minimum emergency
371	371	preparedness standards and requirements for the administration of
372	372	anesthesia under a permit issued under this subchapter. The rules
373	373	must require a permit holder to:
374	374	(1) have available at any location at which the permit
375	375	holder administers anesthesia:
376	376	(A) an adequate and unexpired supply of drugs and
377	377	anesthetic agents necessary for the safe administration of
378	378	anesthesia; and
379	379	(B) an automated external defibrillator, as
380	380	defined by Section 779.001, Health and Safety Code;
381	381	(2) conduct periodic inspections of the permit
382	382	holder's equipment in the manner and on the schedule determined by
383	383	the board;
384	384	(3) maintain and make available to the board on
385	385	request an equipment readiness log; and
386	386	(4) develop and annually update written policies,
387	387	procedures, and training requirements, specific to the permit
388	388	holder's equipment and drugs, for responding to emergency
389	389	situations involving anesthesia.
390	390	(b) Rules adopted under Subsection (a)(4) must require a
391	391	holder of a level 2, level 3, or level 4 permit to develop policies
392	392	and procedures that include:
393	393	(1) advanced cardiac life support rescue protocols;
394	394	(2) advanced airway management techniques; and
395	395	(3) if the permit holder is authorized to administer
396	396	anesthesia to pediatric patients, pediatric advanced life support
397	397	rescue protocols.
398	398	SECTION 19. Section 258.156, Occupations Code, is amended
399	399	to read as follows:
400	400	Sec. 258.156. INSPECTIONS. (a) Except as provided by
401	401	Subsection (g), the [The] board may conduct inspections of a
402	402	dentist who applies for or holds a permit issued under this
403	403	subchapter as necessary to enforce this subchapter, including
404	404	inspections of an office site, equipment, a facility, and any
405	405	document of the [documents of a] dentist [dentist's practice that
406	406	relate to the enteral administration of anesthesia].
407	407	(b) The board shall conduct an inspection with respect to a
408	408	dentist who holds a level 2, level 3, or level 4 permit not less than
409	409	once every five years. The board shall adopt a risk-based
410	410	inspection schedule for inspections required by this subsection.
411	411	(c) The board may contract with another state agency or
412	412	qualified person to conduct these inspections.
413	413	(d) The [(b) Unless it would jeopardize an ongoing
414	414	investigation, the] board is not required to give [shall provide at
415	415	least five business days'] notice before conducting an [on-site]
416	416	inspection under this section.
417	417	(e) The board shall maintain records of inspections
418	418	conducted under this section.
419	419	(f) The board by rule may establish education and training
420	420	requirements for inspectors who conduct inspections under this
421	421	section.
422	422	(g) The board may not conduct an inspection under this
423	423	section with respect to a dentist who administers anesthesia
424	424	exclusively in a state-licensed hospital or state-licensed
425	425	ambulatory surgical center. The board may by rule except from
426	426	inspection under this section a dentist who administers anesthesia
427	427	exclusively in any other facility that is subject to inspection by
428	428	the Department of State Health Services or an accrediting body
429	429	under state law. The board retains all other authority provided by
430	430	this subtitle over a dentist described by this subsection
431	431	[(c) This section does not require the board to make an on-site
432	432	inspection of a dentist's office].
433	433	SECTION 20. Chapter 263, Occupations Code, is amended by
434	434	adding Section 263.0025 to read as follows:
435	435	Sec. 263.0025. SUBMISSION TO MENTAL OR PHYSICAL EVALUATION.
436	436	(a) In enforcing Section 263.002(a)(1), (7), or (11), the board or
437	437	an authorized agent of the board, on probable cause, as determined
438	438	by the board or agent, may request a license holder to submit to a
439	439	mental or physical evaluation by a physician or other health care
440	440	professional designated by the board.
441	441	(b) If the license holder refuses to submit to the
442	442	evaluation under Subsection (a), the board shall issue an order
443	443	requiring the license holder to show cause why the license holder
444	444	will not submit to the evaluation. The board shall schedule a
445	445	hearing on the order not later than the 30th day after the date
446	446	notice is served on the license holder. The board shall notify the
447	447	license holder of the order and hearing by personal service or
448	448	certified mail, return receipt requested.
449	449	(c) At the hearing, the license holder and the license
450	450	holder's attorney are entitled to present testimony or other
451	451	evidence to show why the license holder should not be required to
452	452	submit to the evaluation. The license holder has the burden of
453	453	proof to show why the license holder should not be required to
454	454	submit to the evaluation.
455	455	(d) After the hearing, the board by order shall require the
456	456	license holder to submit to the evaluation not later than the 60th
457	457	day after the date of the order or withdraw the request for an
458	458	evaluation, as applicable.
459	459	SECTION 21. Section 263.0065(c), Occupations Code, is
460	460	amended to read as follows:
461	461	(c) A complaint delegated under this section shall be
462	462	referred for informal proceedings under Section 263.007 [263.0075]
463	463	if:
464	464	(1) the committee of employees determines that the
465	465	complaint should not be dismissed or settled;
466	466	(2) the committee is unable to reach an agreed
467	467	settlement; or
468	468	(3) the affected license holder requests that the
469	469	complaint be referred for informal proceedings.
470	470	SECTION 22. Section 263.007, Occupations Code, is amended
471	471	by amending Subsection (b) and adding Subsections (c) through (k)
472	472	to read as follows:
473	473	(b) Rules adopted under this section must require that:
474	474	(1) not later than the 180th day after the date the
475	475	board's official investigation of a complaint is commenced, the
476	476	board schedule an informal settlement conference unless good cause
477	477	is shown by the board for not scheduling the conference by that
478	478	date;
479	479	(2) the board give notice to the license holder of the
480	480	time and place of the conference not later than the 45th day before
481	481	the date the conference is held;
482	482	(3) the complainant and the license holder be provided
483	483	an opportunity to be heard;
484	484	(4) the board's legal counsel or a representative of
485	485	the attorney general be present to advise the board or the board's
486	486	staff; and
487	487	(5) a member of the board's staff be at the conference
488	488	to present the facts the staff reasonably believes the board could
489	489	prove at a hearing by competent evidence or qualified witnesses
490	490	[provide the complainant, if applicable and permitted by law, an
491	491	opportunity to be heard;
492	492	[(2) provide the license holder an opportunity to be
493	493	heard; and
494	494	[(3) require the presence of a member of the board's
495	495	legal staff, if the board has a legal staff, or, if the board does
496	496	not have a legal staff, an attorney from the attorney general's
497	497	office to advise the board or the board's employees].
498	498	(c) The license holder is entitled at the conference to:
499	499	(1) reply to the staff's presentation; and
500	500	(2) present the facts the license holder reasonably
501	501	believes the license holder could prove at a hearing by competent
502	502	evidence or qualified witnesses.
503	503	(d) After ample time is given for the presentations, the
504	504	informal settlement conference panel shall recommend that the
505	505	investigation be closed or make a recommendation regarding the
506	506	disposition of the case in the absence of a hearing under applicable
507	507	law concerning contested cases.
508	508	(e) If the license holder has previously been the subject of
509	509	disciplinary action by the board, the board shall schedule the
510	510	informal settlement conference as soon as practicable but not later
511	511	than the 180th day after the date the board's official
512	512	investigation of the complaint is commenced.
513	513	(f) A notice under Subsection (b)(2) must be accompanied by
514	514	a written statement of the nature of the allegations and the
515	515	information the board intends to use at the informal settlement
516	516	conference. If the board does not provide the statement or
517	517	information at that time, the license holder may use that failure as
518	518	grounds for rescheduling the conference. If the complaint includes
519	519	an allegation that the license holder has violated the standard of
520	520	care in the practice of dentistry or dental hygiene, the notice must
521	521	include a copy of the report by the expert reviewer. The license
522	522	holder must provide to the board the license holder's rebuttal not
523	523	later than the 15th day before the date of the conference in order
524	524	for that information to be considered at the conference.
525	525	(g) The board by rule shall define circumstances
526	526	constituting good cause for purposes of Subsection (b)(1),
527	527	including an expert reviewer's delinquency in reviewing and
528	528	submitting a report to the board under Section 255.0067.
529	529	(h) The board by rule shall define circumstances
530	530	constituting good cause to grant a request by a license holder for a
531	531	continuance of the informal settlement conference.
532	532	(i) Information presented by the board or board staff in an
533	533	informal settlement conference is confidential and not subject to
534	534	disclosure under Chapter 552, Government Code.
535	535	(j) On request by the license holder under review, the board
536	536	shall make a recording of the informal settlement conference
537	537	proceeding. The recording is a part of the investigative file and
538	538	may not be released to a third party unless authorized under this
539	539	subtitle. The board may charge the license holder a fee to cover
540	540	the cost of recording the proceeding.
541	541	(k) The board shall provide a copy of the recording to the
542	542	license holder on the license holder's request.
543	543	SECTION 23. Chapter 263, Occupations Code, is amended by
544	544	adding Sections 263.0071, 263.0072, and 263.0073 to read as
545	545	follows:
546	546	Sec. 263.0071. DENTAL REVIEW COMMITTEE. (a) The dental
547	547	review committee consists of nine members appointed by the governor
548	548	as follows:
549	549	(1) six dentist members; and
550	550	(2) three dental hygienist members.
551	551	(b) A member of the committee serves a six-year term.
552	552	(c) If a vacancy occurs during a member's term, the governor
553	553	shall appoint a replacement to fill the unexpired term.
554	554	(d) A member of the committee is entitled to receive a per
555	555	diem for actual duty in the same manner provided for board members.
556	556	(e) A member of the committee is subject to law and the rules
557	557	of the board, including Sections 252.003, 252.007, and 252.010, as
558	558	if the committee member were a member of the board, except that a
559	559	committee member is not subject to Chapter 572, Government
560	560	Code. The training program a committee member must complete under
561	561	Section 252.010 must be an abbreviated version of the program under
562	562	that section that is limited to training relevant to serving on a
563	563	committee.
564	564	Sec. 263.0072. INFORMAL SETTLEMENT CONFERENCE PANEL. (a)
565	565	The board shall appoint members of the board and the dental review
566	566	committee to serve, on a rotating basis, as panelists on an informal
567	567	settlement conference panel for purposes of this section.
568	568	(b) In an informal settlement conference under Section
569	569	263.007, the board shall appoint at least two panelists to
570	570	determine whether an informal disposition is appropriate. At least
571	571	one of the panelists must be a dentist.
572	572	(c) The board by rule shall require that at least one
573	573	panelist be physically present at the informal settlement
574	574	conference and may authorize another panelist to appear by video
575	575	conference.
576	576	(d) Notwithstanding Subsection (b), an informal settlement
577	577	conference may be conducted by one panelist if the license holder
578	578	who is the subject of the complaint waives the requirement that at
579	579	least two panelists conduct the conference. If the license holder
580	580	waives that requirement, the panelist may be a dentist, a dental
581	581	hygienist, or a member who represents the public.
582	582	(e) Notwithstanding Subsections (b) and (d), an informal
583	583	settlement conference conducted under Section 263.007 to show
584	584	compliance with an order or remedial plan of the board may be
585	585	conducted by one panelist.
586	586	Sec. 263.0073. ROLES AND RESPONSIBILITIES OF PARTICIPANTS
587	587	IN INFORMAL SETTLEMENT CONFERENCE. (a) At an informal settlement
588	588	conference under Section 263.007, the panel shall make
589	589	recommendations for the disposition of the complaint or allegation.
590	590	The panel may request the assistance of a board employee at any
591	591	time.
592	592	(b) Board employees shall present a summary of the
593	593	allegations against the license holder and of the facts pertaining
594	594	to the allegation that the employees reasonably believe may be
595	595	proven by competent evidence at a formal hearing.
596	596	(c) An attorney for the board shall act as counsel to the
597	597	panel and shall be present during the informal settlement
598	598	conference and the panel's deliberations to advise the panel on
599	599	legal issues that arise during the proceeding. The attorney may ask
600	600	questions of participants in the conference to clarify any
601	601	statement made by the participant. The attorney shall provide to
602	602	the panel a historical perspective on comparable cases that have
603	603	appeared before the board, keep the proceedings focused on the case
604	604	being discussed, and ensure that the board's employees and the
605	605	license holder have an opportunity to present information related
606	606	to the case. During the panel's deliberations, the attorney may be
607	607	present only to advise the panel on legal issues and to provide
608	608	information on comparable cases that have appeared before the
609	609	board.
610	610	(d) The panel and board employees shall provide an
611	611	opportunity for the license holder and the license holder's
612	612	authorized representative to reply to the board employees'
613	613	presentation and to present oral and written statements and facts
614	614	that the license holder and representative reasonably believe could
615	615	be proven by competent evidence at a formal hearing.
616	616	(e) An employee of the board who participated in the
617	617	presentation of the allegation or information gathered in the
618	618	investigation of the complaint, the license holder, the license
619	619	holder's authorized representative, the complainant, the
620	620	witnesses, and members of the public may not be present during the
621	621	deliberations of the panel. Only the members of the panel and the
622	622	attorney serving as counsel to the panel may be present during the
623	623	deliberations.
624	624	(f) During the deliberations, the panel may not reconsider
625	625	an expert panel's determinations that are included in a final
626	626	written report issued under Section 255.0067.
627	627	(g) The panel shall recommend the dismissal of the complaint
628	628	or allegations or, if the panel determines that the license holder
629	629	has violated a statute or board rule, may recommend board action and
630	630	terms for an informal settlement of the case.
631	631	(h) The panel's recommendations under Subsection (g) must
632	632	be made in writing and presented to the license holder and the
633	633	license holder's authorized representative. The license holder may
634	634	accept the proposed settlement within the time established by the
635	635	panel at the informal settlement conference. If the license holder
636	636	rejects the proposed settlement or does not act within the required
637	637	time, the board may proceed with the filing of a formal complaint
638	638	with the State Office of Administrative Hearings.
639	639	SECTION 24. Section 264.011, Occupations Code, is amended
640	640	to read as follows:
641	641	Sec. 264.011. INFORMAL ASSESSMENT OF ADMINISTRATIVE
642	642	PENALTY. This subchapter does not prevent the board from assessing
643	643	an administrative penalty using an informal proceeding under
644	644	Section 263.007 [263.003].
645	645	SECTION 25. Section 265.001, Occupations Code, is amended
646	646	to read as follows:
647	647	Sec. 265.001. REGISTRATION. (a) The board may adopt and
648	648	enforce rules requiring the registration of dental assistants as
649	649	necessary to protect the public health and safety.
650	650	(b) This section expires September 1, 2018.
651	651	SECTION 26. Chapter 265, Occupations Code, is amended by
652	652	adding Sections 265.0015, 265.0016, 265.0017, and 265.0018 to read
653	653	as follows:
654	654	Sec. 265.0015. REGISTRATION REQUIRED FOR CERTAIN DENTAL
655	655	ACTS. Unless a dental assistant is registered under this chapter, a
656	656	dental assistant may not:
657	657	(1) apply a pit and fissure sealant;
658	658	(2) make a dental x-ray;
659	659	(3) perform coronal polishing; or
660	660	(4) monitor the administration of nitrous oxide.
661	661	Sec. 265.0016. ELIGIBILITY REQUIREMENTS FOR REGISTRATION.
662	662	(a) The board by rule shall establish the requirements for
663	663	registration under this chapter, including requiring a dental
664	664	assistant to:
665	665	(1) hold a high school diploma or its equivalent;
666	666	(2) complete an educational program approved by the
667	667	board that includes courses of instruction on:
668	668	(A) the dental acts described by Section
669	669	265.0015;
670	670	(B) basic life support;
671	671	(C) infection control; and
672	672	(D) jurisprudence;
673	673	(3) pass an examination approved or administered by
674	674	the board; and
675	675	(4) meet any additional qualifications established by
676	676	the board.
677	677	(b) The board may approve courses of instruction and
678	678	examinations that are provided by private entities for the purposes
679	679	of this section.
680	680	Sec. 265.0017. FEES. The board shall set and collect fees
681	681	in amounts that are reasonable and necessary to cover the costs of
682	682	administering this chapter, including registration and renewal
683	683	fees.
684	684	Sec. 265.0018. REGISTRATION EXPIRATION AND RENEWAL. (a) A
685	685	registration under this chapter is valid for two years.
686	686	(b) A dental assistant may renew a registration by paying
687	687	the required renewal fee and complying with any other renewal
688	688	requirements established by the board.
689	689	(c) A dental assistant whose registration has expired may
690	690	not engage in an activity that requires registration until the
691	691	registration has been renewed.
692	692	(d) The board by rule may adopt a system under which
693	693	registrations expire on various dates during the year. For the year
694	694	in which the expiration date is changed, the board shall prorate
695	695	registration fees on a monthly basis so that each registration
696	696	holder pays only that portion of the registration fee that is
697	697	allocable to the number of months during which the registration is
698	698	valid. On renewal of the registration on the new expiration date,
699	699	the total renewal fee is payable.
700	700	SECTION 27. Section 265.003, Occupations Code, is amended
701	701	by amending Subsections (a) and (a-1) and adding Subsections (c)
702	702	and (d) to read as follows:
703	703	(a) A dental assistant who is not registered under this
704	704	chapter [professionally licensed] may be employed by and work in
705	705	the office of a licensed and practicing dentist and perform one or
706	706	more delegated dental acts under:
707	707	(1) the direct supervision, direction, and
708	708	responsibility of the dentist, including[:
709	709	[(A) the application of a pit and fissure
710	710	sealant;
711	711	[(B) coronal polishing, if the dental assistant
712	712	holds a certificate under Section 265.006; and
713	713	[(C)] the application of fluoride varnish; or
714	714	(2) the general supervision, direction, and
715	715	responsibility of the dentist, limited to[:
716	716	[(A) the making of dental x-rays in compliance
717	717	with Section 265.005; and
718	718	[(B)] the provision of interim treatment of a
719	719	minor emergency dental condition to an existing patient of the
720	720	treating dentist.
721	721	(a-1) A treating dentist who delegates the provision of
722	722	interim treatment of a minor emergency dental condition to a dental
723	723	assistant under Subsection (a)(2) [(a)(2)(B)] shall:
724	724	(1) delegate the procedure orally or in writing before
725	725	the dental assistant performs the procedure;
726	726	(2) retain responsibility for the procedure; and
727	727	(3) schedule a follow-up appointment with the patient
728	728	within a reasonable time.
729	729	(c) A delegating dentist remains responsible for the dental
730	730	acts of a registered or nonregistered dental assistant performing
731	731	the delegated dental acts.
732	732	(d) A dental assistant to whom a delegation is made may not
733	733	represent to the public that the dental assistant is authorized to
734	734	practice dentistry or dental hygiene.
735	735	SECTION 28. Section 265.004, Occupations Code, is amended
736	736	by adding Subsection (f) to read as follows:
737	737	(f) This section expires September 1, 2018.
738	738	SECTION 29. Section 265.005, Occupations Code, is amended
739	739	by adding Subsection (p) to read as follows:
740	740	(p) This section expires September 1, 2018.
741	741	SECTION 30. Section 265.006, Occupations Code, is amended
742	742	by adding Subsection (c) to read as follows:
743	743	(c) This section expires September 1, 2018.
744	744	SECTION 31. Section 265.007, Occupations Code, is amended
745	745	by adding Subsection (d) to read as follows:
746	746	(d) This section expires September 1, 2018.
747	747	SECTION 32. Chapter 265, Occupations Code, is amended by
748	748	adding Sections 265.008 and 265.009 to read as follows:
749	749	Sec. 265.008. CONTINUING EDUCATION REQUIRED FOR
750	750	REGISTRATION RENEWAL. The board by rule shall establish continuing
751	751	education requirements for dental assistants registered under this
752	752	chapter, including a minimum number of hours of continuing
753	753	education required to renew a registration.
754	754	Sec. 265.009. GROUNDS FOR DISCIPLINARY ACTION. (a) The
755	755	board, after notice and hearing, may reprimand a person registered
756	756	under this chapter, issue a warning letter to a person registered
757	757	under this chapter, impose a fine on a person registered under this
758	758	chapter, impose an administrative penalty under Subchapter A,
759	759	Chapter 264, on a person registered under this chapter, place on
760	760	probation with conditions a person whose registration has been
761	761	suspended, or revoke or suspend a person's registration issued
762	762	under this chapter.
763	763	(b) The board by rule shall establish the grounds and
764	764	procedures for disciplinary action under this chapter.
765	765	(c) A proceeding under this section is subject to Chapter
766	766	2001, Government Code.
767	767	SECTION 33. The heading to Subchapter C, Chapter 266,
768	768	Occupations Code, is amended to read as follows:
769	769	SUBCHAPTER C. BOARD POWERS AND DUTIES [OF COUNCIL AND BOARD]
770	770	SECTION 34. The following provisions of the Occupations
771	771	Code are repealed:
772	772	(1) Sections 256.0531(h), (i), and (j);
773	773	(2) Section 262.001(1);
774	774	(3) Subchapter B, Chapter 262;
775	775	(4) Section 262.102(c);
776	776	(5) Section 262.1025;
777	777	(6) Section 262.103;
778	778	(7) Section 263.0075;
779	779	(8) Section 263.0076;
780	780	(9) Section 266.001(1);
781	781	(10) Subchapter B, Chapter 266;
782	782	(11) Section 266.101; and
783	783	(12) Sections 266.102(a) and (d).
784	784	SECTION 35. Not later than March 1, 2018, the State Board of
785	785	Dental Examiners shall:
786	786	(1) adopt rules and fees necessary to implement
787	787	Chapters 258 and 265, Occupations Code, as amended by this Act; and
788	788	(2) adopt rules necessary to implement Chapter 263,
789	789	Occupations Code, as amended by this Act.
790	790	SECTION 36. (a) The term of a member of the State Board of
791	791	Dental Examiners serving on September 1, 2017, expires on that
792	792	date.
793	793	(b) Not later than December 1, 2017, the governor shall
794	794	appoint 11 members to the State Board of Dental Examiners in
795	795	accordance with Section 252.001(a), Occupations Code, as amended by
796	796	this Act. The governor shall appoint:
797	797	(1) two dentist members and one dental hygienist
798	798	member to terms expiring February 1, 2019;
799	799	(2) two dentist members, one dental hygienist member,
800	800	and one public member to terms expiring February 1, 2021; and
801	801	(3) two dentist members, one dental hygienist member,
802	802	and one public member to terms expiring February 1, 2023.
803	803	(c) Notwithstanding Section 252.001, Occupations Code, as
804	804	amended by this Act, the members whose terms expire under
805	805	Subsection (a) of this section shall continue to perform the duties
806	806	of office as a 15-member board until six members are appointed under
807	807	Subsection (b) of this section and qualified.
808	808	(d) The governor may appoint to the board under Subsection
809	809	(b) of this section a member whose term expires under Subsection (a)
810	810	of this section. The expired term of a member described by this
811	811	subsection does not constitute a full term for purposes of Section
812	812	252.004(b), Occupations Code.
813	813	SECTION 37. Not later than December 1, 2017, the presiding
814	814	officer of the State Board of Dental Examiners shall appoint the
815	815	members of the advisory committee established under Section
816	816	258.1521, Occupations Code, as added by this Act.
817	817	SECTION 38. Not later than December 1, 2017, the governor
818	818	shall appoint the members of the dental review committee in
819	819	accordance with Section 263.0071, Occupations Code, as added by
820	820	this Act. In making the appointments, the governor shall appoint:
821	821	(1) three members to terms expiring February 1, 2019;
822	822	(2) three members to terms expiring February 1, 2021;
823	823	and
824	824	(3) three members to terms expiring February 1, 2023.
825	825	SECTION 39. (a) Except as provided by Subsection (b) of this
826	826	section, Section 252.010, Occupations Code, as amended by this Act,
827	827	applies to a member of the State Board of Dental Examiners appointed
828	828	before, on, or after the effective date of this Act.
829	829	(b) A member of the board appointed after the effective date
830	830	of this Act who, before the effective date of this Act, completed
831	831	the training program required by Section 252.010, Occupations Code,
832	832	as that law existed before the effective date of this Act, is
833	833	required to complete additional training only on the subjects added
834	834	by this Act to the training program as required by Section 252.010,
835	835	Occupations Code. A board member described by this subsection may
836	836	not vote, deliberate, or be counted as a member in attendance at a
837	837	meeting of the board held on or after December 1, 2017, until the
838	838	member completes the additional training.
839	839	SECTION 40. Section 258.0535, Occupations Code, as added by
840	840	this Act, applies only to a prescription issued on or after
841	841	September 1, 2018. A prescription issued before September 1, 2018,
842	842	is governed by the law in effect on the date the prescription was
843	843	issued, and the former law is continued in effect for that purpose.
844	844	SECTION 41. Section 265.008, Occupations Code, as added by
845	845	this Act, applies only to the renewal of a registration on or after
846	846	September 1, 2018.
847	847	SECTION 42. (a) On September 1, 2018, a registration or
848	848	certificate issued under former Section 265.001, 265.004, 265.005,
849	849	or 265.006, Occupations Code, expires.
850	850	(b) As soon as practicable after September 1, 2018, the
851	851	State Board of Dental Examiners shall issue a prorated refund of any
852	852	fees paid by a holder of a registration or certificate that expires
853	853	under Subsection (a) of this section.
854	854	SECTION 43. (a) Chapter 263, Occupations Code, as amended
855	855	by this Act, applies only to the investigation or disposition of a
856	856	complaint filed with the State Board of Dental Examiners on or after
857	857	March 1, 2018. A complaint filed before that date is governed by
858	858	the law in effect on the date the complaint was filed, and the
859	859	former law is continued in effect for that purpose.
860	860	(b) The changes in law made by this Act do not affect the
861	861	validity of a disciplinary action or other proceeding that was
862	862	initiated before the effective date of this Act and that is pending
863	863	before a court or other governmental entity on that date.
864	864	SECTION 44. (a) A violation of a law that is repealed by
865	865	this Act is governed by the law in effect on the date the violation
866	866	was committed, and the former law is continued in effect for that
867	867	purpose.
868	868	(b) For purposes of this section, a violation was committed
869	869	before the effective date of this Act if any element of the
870	870	violation occurred before that date.
871	871	SECTION 45. (a) Except as provided by Subsections (b) and
872	872	(c) of this section, this Act takes effect September 1, 2017.
873	873	(b) Section 258.155, Occupations Code, as amended by this
874	874	Act, and Sections 258.1552 and 258.1553, Occupations Code, as added
875	875	by this Act, take effect March 1, 2018.
876	876	(c) Sections 258.002 and 258.054, Occupations Code, as
877	877	amended by this Act, and Section 265.0015, Occupations Code, as
878	878	added by this Act, take effect September 1, 2018.