Wisconsin 2023-2024 Regular Session

Wisconsin Assembly Bill AB668 Compare Versions

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

Old	New	Differences
1	1	LRB-5024/1
2	2	MED:cdc/wlj/skw
3	3	2023 - 2024 LEGISLATURE
4	4	2023 ASSEMBLY BILL 668
5	5	November 14, 2023 - Introduced by Representatives PLUMER, ROZAR, CALLAHAN,
6	6	OLDENBURG, BINSFELD, DITTRICH, EMERSON, GOEBEN, JACOBSON, JOERS,
7	7	MURSAU, OHNSTAD, ORTIZ-VELEZ, SNYDER, TUSLER and BEHNKE, cosponsored by
8	8	Senators FELZKOWSKI, JAMES, MARKLEIN, SPREITZER, TESTIN, HUTTON and ROYS.
9	9	Referred to Committee on Health, Aging and Long-Term Care.
10	10	*AUTHORS SUBJECT TO CHANGE*
11	11	AN ACT to amend 15.405 (6) (b), 36.61 (1) (b), 36.61 (3) (a), 36.61 (5) (b) 1., 36.61
12	12	(8) (c) 3., 146.81 (1) (c), 146.89 (1) (r) 1., 146.89 (1) (r) 5., 146.89 (3) (b) 8., 146.89
13	13	(3m) (intro.), 146.997 (1) (d) 3., 155.01 (7), 252.14 (1) (ar) 3., 257.01 (5) (a), 257.01
14	14	(5) (b), 440.094 (1) (c) 3., 447.02 (1) (a), 447.02 (1) (b), 447.02 (2) (a), 447.02 (3)
15	15	(a) (intro.), 447.02 (3) (a) 2., 447.02 (3) (b), 447.02 (5), 447.03 (3) (c), 447.06 (1),
16	16	447.06 (2) (a) 3., 447.06 (2) (b), 447.06 (2) (c) (intro.), 447.06 (2) (c) 2. (intro.),
17	17	447.063, 447.065, 447.07 (1), 447.07 (3) (intro.), 447.07 (3) (e) to (h), 447.40
18	18	(intro.), 447.40 (6), 448.03 (2) (a), 448.975 (2) (c) 1., 450.03 (1) (e), 450.10 (3) (a)
19	19	4., 462.02 (2) (d), 462.04, 463.10 (5), 463.12 (5), 632.87 (4), 895.48 (1m) (a)
20	20	(intro.), 895.48 (1m) (a) 2. and 941.315 (5); and to create 36.61 (1) (ak), 440.03
21	21	(13) (b) 20m., 440.08 (2) (a) 25m., 447.01 (6g), 447.01 (6r), 447.02 (1) (g), 447.02
22	22	(3) (a) 3., 447.02 (6), 447.03 (1m), 447.03 (3) (am), 447.04 (1m), 447.05 (2m),
23	23	447.057, 447.06 (1m), 447.06 (3) and 447.07 (6) of the statutes; relating to:
24	24	licensure of dental therapists; extending the time limit for emergency rule
25	25	1
26	26	2
27	27	3
28	28	4
29	29	5
30	30	6
31	31	7
32	32	8
33	33	9
34	34	10
35	35	11
36	36	12
37	37	13
38	38	14 - 2 -2023 - 2024 Legislature LRB-5024/1
39	39	MED:cdc/wlj/skw
40	40	ASSEMBLY BILL 668
41	41	procedures; providing an exemption from emergency rule procedures;
42	42	providing an exemption from rule-making procedures; and granting
43	43	rule-making authority.
44	44	Analysis by the Legislative Reference Bureau
45	45	This bill provides for the licensure of dental therapists, who are health care
46	46	practitioners who may engage in the limited practice of dentistry.
47	47	Under current law, dentists and dental hygienists are licensed by the Dentistry
48	48	Examining Board to practice dentistry and dental hygiene, respectively. This bill
49	49	provides for the licensure of a third type of dental practitioner, dental therapists.
50	50	Under the bill, the board must grant a dental therapist license to an individual who
51	51	satisfies certain criteria, including completion of a qualifying dental therapy
52	52	education program and passage of required examinations.
53	53	Under the bill, a dental therapy education program qualifies if the program 1)
54	54	is accredited by the American Dental Association's Commission on Dental
55	55	Accreditation (CODA); 2) is a program approved by the Minnesota Board of Dentistry
56	56	on or before the bill's effective date that has, as of the time of application, become
57	57	CODA-accredited; or 3) is a program offered in Wisconsin that has received initial
58	58	CODA accreditation but is not yet fully CODA-accredited. With respect to the third
59	59	category of dental therapy education programs (programs offered in Wisconsin), the
60	60	bill allows applicants to obtain a license on the basis of graduation from such a
61	61	program only for four years after the program's inception, and if the program is not
62	62	fully CODA-accredited by the time that four-year period has elapsed, the bill
63	63	requires the licenses of dental therapists who graduated from the program to be
64	64	revoked.
65	65	Under the bill, dental therapists may provide dental therapy services only as
66	66	an employee of specified employers and only under the supervision of a dentist who
67	67	is either similarly employed or who directly employs the dental therapist. The dental
68	68	therapist must also have a collaborative management agreement with a dentist that
69	69	addresses various aspects of the dental therapist's practice and supervision. Dental
70	70	therapists are, subject to the terms of a collaborative management agreement and
71	71	what was covered in their dental therapy education program, limited to providing
72	72	services, treatments, and procedures that are specified in the bill, as well as
73	73	additional services, treatments, or procedures specified by the board by rule. Dental
74	74	therapists may initially provide dental therapy services only under the direct or
75	75	indirect supervision of a qualifying dentist. Once a dental therapist licensed has
76	76	provided dental therapy services for at least 2,000 hours, the dental therapist may
77	77	provide services under the general supervision of a qualifying dentist. However, the
78	78	level of supervision for a dental therapist may be further limited under the terms of
79	79	a collaborative management agreement. Dental therapists must also, under the bill,
80	80	either 1) limit their practice to federally defined dental shortage areas or 2) practice
81	81	in settings where at least 50 percent of their patient base consists of certain specified
82	82	1
83	83	2
84	84	3 - 3 -2023 - 2024 Legislature
85	85	LRB-5024/1
86	86	MED:cdc/wlj/skw
87	87	ASSEMBLY BILL 668
88	88	populations. Dental therapists must complete 12 hours of continuing education each
89	89	biennium.
90	90	The bill subjects dental therapists to, or covers dental therapists under, various
91	91	other laws, including the health care records law, the volunteer health care provider
92	92	program, the health care worker protection law, and the emergency volunteer health
93	93	care practitioner law. The bill also provides for loan forgiveness for dental therapists
94	94	under the health care provider loan assistance program.
95	95	Finally, the bill requires, effective when 50 individuals become licensed as a
96	96	dental therapist in this state or five years after the bill is enacted, that, to the extent
97	97	possible, one of the dental hygienist members on the board also be licensed as a
98	98	dental therapist.
99	99	For further information see the state fiscal estimate, which will be printed as
100	100	an appendix to this bill.
101	101	The people of the state of Wisconsin, represented in senate and assembly, do
102	102	enact as follows:
103	103	SECTION 1. 15.405 (6) (b) of the statutes is amended to read:
104	104	15.405 (6) (b) Three dental hygienists who are licensed under ch. 447. The
105	105	governor shall, to the extent possible, appoint members under this paragraph so that
106	106	at least one of the members under this paragraph is an individual who is also a dental
107	107	therapist licensed under ch. 447. Notwithstanding s. 15.08 (1m) (a), the dental
108	108	hygienist members under this paragraph may participate in the preparation and
109	109	grading of licensing examinations for dental hygienists.
110	110	SECTION 2. 36.61 (1) (ak) of the statutes is created to read:
111	111	36.61 (1) (ak) “Dental therapist” means an individual licensed under s. 447.04
112	112	(1m).
113	113	SECTION 3. 36.61 (1) (b) of the statutes is amended to read:
114	114	36.61 (1) (b) “Health care provider" means a dental therapist, dental hygienist,
115	115	physician assistant, nurse-midwife, or nurse practitioner.
116	116	SECTION 4. 36.61 (3) (a) of the statutes is amended to read:
117	117	1
118	118	2
119	119	3
120	120	4
121	121	5
122	122	6
123	123	7
124	124	8
125	125	9
126	126	10
127	127	11
128	128	12
129	129	13
130	130	14 - 4 -2023 - 2024 Legislature LRB-5024/1
131	131	MED:cdc/wlj/skw
132	132	SECTION 4 ASSEMBLY BILL 668
133	133	36.61 (3) (a) The board shall enter into a written agreement with the health
134	134	care provider. In the agreement, the health care provider shall agree to practice at
135	135	least 32 clinic hours per week for 3 years in one or more eligible practice areas in this
136	136	state or in a rural area, except that a health care provider in the expanded loan
137	137	assistance program under sub. (8) who is not a dental therapist or dental hygienist
138	138	may only agree to practice at a public or private nonprofit entity in a health
139	139	professional shortage area.
140	140	SECTION 5. 36.61 (5) (b) 1. of the statutes is amended to read:
141	141	36.61 (5) (b) 1. The degree to which there is an extremely high need for medical
142	142	care in the eligible practice area, health professional shortage area, or rural area in
143	143	which an eligible applicant who is not a dental therapist or dental hygienist desires
144	144	to practice and the degree to which there is an extremely high need for dental care
145	145	in the dental health shortage area or rural area in which an eligible applicant who
146	146	is a dental therapist or dental hygienist desires to practice.
147	147	SECTION 6. 36.61 (8) (c) 3. of the statutes is amended to read:
148	148	36.61 (8) (c) 3. Practice at a public or private nonprofit entity in a health
149	149	professional shortage area, if the health care provider is not a dental therapist or
150	150	dental hygienist, or in a dental health shortage area, if the health care provider is
151	151	a dental therapist or dental hygienist.
152	152	SECTION 7. 146.81 (1) (c) of the statutes is amended to read:
153	153	146.81 (1) (c) A dentist or dental therapist licensed under ch. 447.
154	154	SECTION 8. 146.89 (1) (r) 1. of the statutes is amended to read:
155	155	146.89 (1) (r) 1. Licensed as a physician under ch. 448, naturopathic doctor
156	156	under ch. 466, a dentist, dental therapist, or dental hygienist under ch. 447, a
157	157	registered nurse, practical nurse, or nurse-midwife under ch. 441, an optometrist
158	158	1
159	159	2
160	160	3
161	161	4
162	162	5
163	163	6
164	164	7
165	165	8
166	166	9
167	167	10
168	168	11
169	169	12
170	170	13
171	171	14
172	172	15
173	173	16
174	174	17
175	175	18
176	176	19
177	177	20
178	178	21
179	179	22
180	180	23
181	181	24
182	182	25 - 5 -2023 - 2024 Legislature
183	183	LRB-5024/1
184	184	MED:cdc/wlj/skw
185	185	SECTION 8
186	186	ASSEMBLY BILL 668
187	187	under ch. 449, a physician assistant under subch. IX of ch. 448, a pharmacist under
188	188	ch. 450, a chiropractor under ch. 446, a podiatrist under subch. IV of ch. 448, or a
189	189	physical therapist under subch. III of ch. 448.
190	190	SECTION 9. 146.89 (1) (r) 5. of the statutes is amended to read:
191	191	146.89 (1) (r) 5. An individual who holds a valid, unexpired license,
192	192	certification, or registration issued by another state or territory that authorizes or
193	193	qualifies the individual to perform acts that are substantially the same as those acts
194	194	that an individual who is described in subds. 1. to 4., except a dentist, dental
195	195	therapist, or dental hygienist, is licensed or certified to perform and who performs
196	196	acts that are within the scope of that license, certification, or registration.
197	197	SECTION 10. 146.89 (3) (b) 8. of the statutes is amended to read:
198	198	146.89 (3) (b) 8. Dental services, including tooth extractions and other
199	199	procedures done under local anesthesia only and any necessary suturing related to
200	200	the extractions, performed by a dentist or dental therapist who is a volunteer health
201	201	provider; and dental hygiene services, performed by a dental hygienist who is a
202	202	volunteer health provider.
203	203	SECTION 11. 146.89 (3m) (intro.) of the statutes is amended to read:
204	204	146.89 (3m) (intro.) A volunteer health care provider who is a dentist or dental
205	205	therapist may provide dental services or a volunteer health care provider who is a
206	206	dental hygienist may provide dental hygiene services, to persons who are recipients
207	207	of Medical Assistance, if all of the following apply:
208	208	SECTION 12. 146.997 (1) (d) 3. of the statutes is amended to read:
209	209	146.997 (1) (d) 3. A dentist or dental therapist licensed under ch. 447.
210	210	SECTION 13. 155.01 (7) of the statutes, as affected by 2021 Wisconsin Act 251,
211	211	is amended to read:
212	212	1
213	213	2
214	214	3
215	215	4
216	216	5
217	217	6
218	218	7
219	219	8
220	220	9
221	221	10
222	222	11
223	223	12
224	224	13
225	225	14
226	226	15
227	227	16
228	228	17
229	229	18
230	230	19
231	231	20
232	232	21
233	233	22
234	234	23
235	235	24
236	236	25 - 6 -2023 - 2024 Legislature LRB-5024/1
237	237	MED:cdc/wlj/skw
238	238	SECTION 13 ASSEMBLY BILL 668
239	239	155.01 (7) “Health care provider" means a nurse licensed or permitted under
240	240	ch. 441, a chiropractor licensed under ch. 446, a dentist or dental therapist licensed
241	241	under ch. 447, a physician, physician assistant, perfusionist, podiatrist, physical
242	242	therapist, physical therapist assistant, occupational therapist, occupational therapy
243	243	assistant, or genetic counselor licensed under ch. 448, a naturopathic doctor licensed
244	244	under ch. 466, a person practicing Christian Science treatment, an optometrist
245	245	licensed under ch. 449, a psychologist who is licensed under ch. 455, who is exercising
246	246	the temporary authorization to practice, as defined in s. 455.50 (2) (o), in this state,
247	247	or who is practicing under the authority to practice interjurisdictional
248	248	telepsychology, as defined in s. 455.50 (2) (b), a physical therapist or physical
249	249	therapist assistant who holds a compact privilege under subch. XI of ch. 448, an
250	250	occupational therapist or occupational therapy assistant who holds a compact
251	251	privilege under subch. XII of ch. 448, a partnership thereof, a corporation or limited
252	252	liability company thereof that provides health care services, a cooperative health
253	253	care association organized under s. 185.981 that directly provides services through
254	254	salaried employees in its own facility, or a home health agency, as defined in s. 50.49
255	255	(1) (a).
256	256	SECTION 14. 252.14 (1) (ar) 3. of the statutes is amended to read:
257	257	252.14 (1) (ar) 3. A dentist or dental therapist licensed under ch. 447.
258	258	SECTION 15. 257.01 (5) (a) of the statutes is amended to read:
259	259	257.01 (5) (a) An individual who is licensed as a physician, a physician
260	260	assistant, or a podiatrist under ch. 448, licensed as a naturopathic doctor under ch.
261	261	466, licensed as a registered nurse, licensed practical nurse, or nurse-midwife under
262	262	ch. 441, licensed as a dentist or dental therapist under ch. 447, licensed as a
263	263	1
264	264	2
265	265	3
266	266	4
267	267	5
268	268	6
269	269	7
270	270	8
271	271	9
272	272	10
273	273	11
274	274	12
275	275	13
276	276	14
277	277	15
278	278	16
279	279	17
280	280	18
281	281	19
282	282	20
283	283	21
284	284	22
285	285	23
286	286	24 - 7 -2023 - 2024 Legislature
287	287	LRB-5024/1
288	288	MED:cdc/wlj/skw
289	289	SECTION 15
290	290	ASSEMBLY BILL 668
291	291	pharmacist under ch. 450, licensed as a veterinarian or certified as a veterinary
292	292	technician under ch. 89, or certified as a respiratory care practitioner under ch. 448.
293	293	SECTION 16. 257.01 (5) (b) of the statutes is amended to read:
294	294	257.01 (5) (b) An individual who was at any time within the previous 10 years,
295	295	but is not currently, licensed as a physician, a physician assistant, or a podiatrist
296	296	under ch. 448, licensed as a naturopathic doctor under ch. 466, licensed as a
297	297	registered nurse, licensed practical nurse or nurse-midwife, under ch. 441, licensed
298	298	as a dentist or dental therapist under ch. 447, licensed as a pharmacist under ch. 450,
299	299	licensed as a veterinarian or certified as a veterinary technician under ch. 89, or
300	300	certified as a respiratory care practitioner under ch. 448, if the individual's license
301	301	or certification was never revoked, limited, suspended, or denied renewal.
302	302	SECTION 17. 440.03 (13) (b) 20m. of the statutes is created to read:
303	303	440.03 (13) (b) 20m. Dental therapist.
304	304	SECTION 18. 440.08 (2) (a) 25m. of the statutes is created to read:
305	305	440.08 (2) (a) 25m. Dental therapist: October 1 of each odd-numbered year.
306	306	SECTION 19. 440.094 (1) (c) 3. of the statutes is amended to read:
307	307	440.094 (1) (c) 3. A dentist or dental therapist licensed under ch. 447.
308	308	SECTION 20. 447.01 (6g) of the statutes is created to read:
309	309	447.01 (6g) “Dental therapist” means an individual who practices dental
310	310	therapy.
311	311	SECTION 21. 447.01 (6r) of the statutes is created to read:
312	312	447.01 (6r) “Dental therapy” means the limited practice of dentistry, consisting
313	313	of the services, treatments, and procedures specified in s. 447.06 (3) (b).
314	314	SECTION 22. 447.02 (1) (a) of the statutes is amended to read:
315	315	1
316	316	2
317	317	3
318	318	4
319	319	5
320	320	6
321	321	7
322	322	8
323	323	9
324	324	10
325	325	11
326	326	12
327	327	13
328	328	14
329	329	15
330	330	16
331	331	17
332	332	18
333	333	19
334	334	20
335	335	21
336	336	22
337	337	23
338	338	24 - 8 -2023 - 2024 Legislature LRB-5024/1
339	339	MED:cdc/wlj/skw
340	340	SECTION 22 ASSEMBLY BILL 668
341	341	447.02 (1) (a) Governing the reexamination of an applicant who fails an
342	342	examination specified in s. 447.04 (1) (a) 5., (1m) (e), or (2) (a) 5. The rules may specify
343	343	additional educational requirements for those applicants and may specify the
344	344	number of times an applicant may be examined.
345	345	SECTION 23. 447.02 (1) (b) of the statutes is amended to read:
346	346	447.02 (1) (b) Governing the standards and conditions for the use of radiation
347	347	and ionizing equipment in the practice of dentistry or dental therapy.
348	348	SECTION 24. 447.02 (1) (g) of the statutes is created to read:
349	349	447.02 (1) (g) Specifying services, treatments, or procedures, in addition to
350	350	those specified under s. 447.06 (3) (b) 1. to 27., that are included within the practice
351	351	of dental therapy.
352	352	SECTION 25. 447.02 (2) (a) of the statutes is amended to read:
353	353	447.02 (2) (a) The conditions for supervision and the degree of supervision
354	354	required under ss. 447.03 (3) (a), (am), (b) and (d) 2. and 447.065.
355	355	SECTION 26. 447.02 (3) (a) (intro.) of the statutes is amended to read:
356	356	447.02 (3) (a) (intro.) The examining board may issue a permit authorizing the
357	357	practice in this state, without compensation, of dentistry, dental therapy, or dental
358	358	hygiene to an applicant who is licensed to practice dentistry, dental therapy, or dental
359	359	hygiene in another state, if all of the following apply:
360	360	SECTION 27. 447.02 (3) (a) 2. of the statutes is amended to read:
361	361	447.02 (3) (a) 2. The examining board determines that the applicant is qualified
362	362	and satisfies the criteria specified under s. 447.04 (1) (b) 1. to 3., except that the
363	363	examining board may not require the applicant to pass an examination of state
364	364	statutes and rules relating to dentistry, dental therapy, or dental hygiene.
365	365	SECTION 28. 447.02 (3) (a) 3. of the statutes is created to read:
366	366	1
367	367	2
368	368	3
369	369	4
370	370	5
371	371	6
372	372	7
373	373	8
374	374	9
375	375	10
376	376	11
377	377	12
378	378	13
379	379	14
380	380	15
381	381	16
382	382	17
383	383	18
384	384	19
385	385	20
386	386	21
387	387	22
388	388	23
389	389	24
390	390	25 - 9 -2023 - 2024 Legislature
391	391	LRB-5024/1
392	392	MED:cdc/wlj/skw
393	393	SECTION 28
394	394	ASSEMBLY BILL 668
395	395	447.02 (3) (a) 3. If the applicant is applying for a permit to practice dental
396	396	therapy, the applicant graduated from a dental therapy education program approved
397	397	under s. 447.04 (1m) (c) 1. to 3.
398	398	SECTION 29. 447.02 (3) (b) of the statutes is amended to read:
399	399	447.02 (3) (b) A permit under this subsection shall authorize the practice of
400	400	dentistry, dental therapy, or dental hygiene in a specified area of the state for a period
401	401	of time not more than 10 days in a year and may be renewed by the examining board.
402	402	The examining board may not require an applicant to pay a fee for the issuance or
403	403	renewal of a permit under this subsection.
404	404	SECTION 30. 447.02 (5) of the statutes is amended to read:
405	405	447.02 (5) Except as provided in ss. 447.058 and 447.063, nothing in this
406	406	chapter may be construed as authorizing the examining board to regulate business
407	407	or administrative support functions or services, that do not constitute the practice
408	408	of dentistry, dental therapy, or dental hygiene, provided to a business that provides
409	409	dental or dental hygiene services.
410	410	SECTION 31. 447.02 (6) of the statutes is created to read:
411	411	447.02 (6) The examining board shall send a notice to the legislative reference
412	412	bureau for publication in the Wisconsin Administrative Register when the board
413	413	determines that 50 or more individuals are currently licensed as dental therapists
414	414	in this state under s. 447.04 (1m). This subsection does not apply on or after the first
415	415	day of the 6th year beginning after publication of this act .... [LRB inserts date].
416	416	SECTION 32. 447.03 (1m) of the statutes is created to read:
417	417	447.03 (1m) DENTAL THERAPISTS. Except as provided under sub. (3) and s.
418	418	447.02 (3), no person may do any of the following unless he or she is licensed to
419	419	practice dental therapy under this chapter:
420	420	1
421	421	2
422	422	3
423	423	4
424	424	5
425	425	6
426	426	7
427	427	8
428	428	9
429	429	10
430	430	11
431	431	12
432	432	13
433	433	14
434	434	15
435	435	16
436	436	17
437	437	18
438	438	19
439	439	20
440	440	21
441	441	22
442	442	23
443	443	24
444	444	25 - 10 -2023 - 2024 Legislature LRB-5024/1
445	445	MED:cdc/wlj/skw
446	446	SECTION 32 ASSEMBLY BILL 668
447	447	(a) Practice or offer to practice dental therapy.
448	448	(b) Represent himself or herself to the public as a dental therapist or use, in
449	449	connection with his or her name, any title or description that may convey the
450	450	impression that he or she is a dental therapist.
451	451	SECTION 33. 447.03 (3) (am) of the statutes is created to read:
452	452	447.03 (3) (am) A dental therapy student who practices dental therapy under
453	453	the supervision of a dentist in an infirmary, clinic, hospital, or other institution
454	454	connected or associated for training purposes with a dental therapy school accredited
455	455	by the American Dental Association commission on dental accreditation or its
456	456	successor agency.
457	457	SECTION 34. 447.03 (3) (c) of the statutes is amended to read:
458	458	447.03 (3) (c) An individual licensed to practice dentistry, dental therapy, or
459	459	dental hygiene in another state or country who practices dentistry, dental therapy,
460	460	or dental hygiene in a program of dental education or research at the invitation of
461	461	a group of dentists or practices dentistry, dental therapy, or dental hygiene under the
462	462	jurisdiction of the army, navy, air force, U.S. public health service, or veterans
463	463	bureau.
464	464	SECTION 35. 447.04 (1m) of the statutes is created to read:
465	465	447.04 (1m) DENTAL THERAPISTS. The examining board shall grant a license to
466	466	practice dental therapy to an individual who does all of the following:
467	467	(a) Submits an application for the license to the department on a form provided
468	468	by the department.
469	469	(b) Pays the fee specified in s. 440.05 (1).
470	470	(c) Submits evidence satisfactory to the examining board that he or she has
471	471	done one of the following:
472	472	1
473	473	2
474	474	3
475	475	4
476	476	5
477	477	6
478	478	7
479	479	8
480	480	9
481	481	10
482	482	11
483	483	12
484	484	13
485	485	14
486	486	15
487	487	16
488	488	17
489	489	18
490	490	19
491	491	20
492	492	21
493	493	22
494	494	23
495	495	24
496	496	25 - 11 -2023 - 2024 Legislature
497	497	LRB-5024/1
498	498	MED:cdc/wlj/skw
499	499	SECTION 35
500	500	ASSEMBLY BILL 668
501	501	1. Graduated from an accredited dental therapy education program.
502	502	2. Graduated from a dental therapy education program that was not accredited
503	503	at the time of graduation, but that satisfies all of the following:
504	504	a. The program was approved by the Minnesota Board of Dentistry on or before
505	505	the effective date of this subd. 2. a. .... [LRB inserts date].
506	506	b. The program was accredited as of the date the individual applies for a license
507	507	under this subsection.
508	508	3. Graduated from a dental therapy education program located in this state
509	509	that, at the time of graduation, was not fully accredited but had received initial
510	510	accreditation. This subdivision applies to a dental therapy education program only
511	511	during the 4-year period beginning after the program's inception. After that 4-year
512	512	period has elapsed, an individual may not qualify for a license under this subsection
513	513	on the basis of graduation from that program unless the program has subsequently
514	514	become accredited as described in subd. 1. The examining board shall maintain a
515	515	register of individuals granted a license on the basis of graduation from a program
516	516	described in this subdivision.
517	517	(d) Submits evidence satisfactory to the examining board that he or she has
518	518	passed a national board dental therapy examination and a dental therapy clinical
519	519	examination administered by a regional testing service that has been approved by
520	520	the examining board to administer clinical examinations for dental professionals.
521	521	If a national board examination or a regional testing service examination for dental
522	522	therapy does not exist, the examining board shall accept evidence of passing an
523	523	alternative examination administered by another entity or testing service that is
524	524	approved by the examining board.
525	525	1
526	526	2
527	527	3
528	528	4
529	529	5
530	530	6
531	531	7
532	532	8
533	533	9
534	534	10
535	535	11
536	536	12
537	537	13
538	538	14
539	539	15
540	540	16
541	541	17
542	542	18
543	543	19
544	544	20
545	545	21
546	546	22
547	547	23
548	548	24 - 12 -2023 - 2024 Legislature LRB-5024/1
549	549	MED:cdc/wlj/skw
550	550	SECTION 35 ASSEMBLY BILL 668
551	551	(e) Passes an examination administered by the examining board on the
552	552	statutes and rules relating to dental therapy.
553	553	(f) Submits evidence satisfactory to the examining board that he or she has
554	554	current proficiency in cardiopulmonary resuscitation, including the use of an
555	555	automated external defibrillator achieved through instruction provided by an
556	556	individual, organization, or institution of higher education approved under s. 46.03
557	557	(38) to provide such instruction.
558	558	(g) If the individual was licensed or is currently licensed in another state or
559	559	territory of the United States or in another country, the individual submits
560	560	information related to his or her licensure in other jurisdictions as required by the
561	561	examining board.
562	562	(h) Completes any other requirements established by the examining board by
563	563	rule that are comparable to and no more restrictive than the requirements
564	564	established by the board for dentists under sub. (1) (a) 6. and dental hygienists under
565	565	sub. (2) (a) 6.
566	566	SECTION 36. 447.05 (2m) of the statutes is created to read:
567	567	447.05 (2m) The examining board may not renew a license to practice dental
568	568	therapy unless the applicant for renewal attests that he or she has complied with s.
569	569	447.057 and any rules promulgated under s. 447.057, that he or she has current
570	570	proficiency in cardiopulmonary resuscitation, and that he or she has current
571	571	proficiency in the use of an automated external defibrillator achieved through
572	572	instruction provided by an individual, organization, or institution of higher
573	573	education approved under s. 46.03 (38) to provide such instruction.
574	574	SECTION 37. 447.057 of the statutes is created to read:
575	575	1
576	576	2
577	577	3
578	578	4
579	579	5
580	580	6
581	581	7
582	582	8
583	583	9
584	584	10
585	585	11
586	586	12
587	587	13
588	588	14
589	589	15
590	590	16
591	591	17
592	592	18
593	593	19
594	594	20
595	595	21
596	596	22
597	597	23
598	598	24 - 13 -2023 - 2024 Legislature
599	599	LRB-5024/1
600	600	MED:cdc/wlj/skw
601	601	SECTION 37
602	602	ASSEMBLY BILL 668
603	603	447.057 Continuing education; dental therapists. (1) (a) Except as
604	604	provided in subs. (3) and (4), a person is not eligible for renewal of a license to practice
605	605	dental therapy, other than a permit issued under s. 447.02 (3), unless the person has
606	606	taught, prepared, attended, or otherwise completed, during the 2-year period
607	607	immediately preceding the renewal date specified under s. 440.08 (2) (a), 12 credit
608	608	hours of continuing education relating to the clinical practice of dental therapy that
609	609	is sponsored or recognized by a local, state, regional, national, or international
610	610	dental, dental therapy, dental hygiene, dental assisting, or medical-related
611	611	professional organization.
612	612	(b) Continuing education required under par. (a) may include training in all of
613	613	the following:
614	614	1. Basic life support or cardiopulmonary resuscitation. Not more than 2 of the
615	615	credit hours required under par. (a) may be satisfied by such training.
616	616	2. Infection control. Not less than 2 of the credit hours required under par. (a)
617	617	must be satisfied by such training.
618	618	(c) After consultation with the department of health services, the examining
619	619	board may promulgate rules requiring that continuing education credit hours under
620	620	par. (a) include courses in specific clinical subjects.
621	621	(2) The credit hours required under sub. (1) (a) may be satisfied by independent
622	622	study, correspondence, or Internet programs or courses.
623	623	(3) Subsection (1) (a) does not apply to an applicant for renewal of a license that
624	624	expires on the first renewal date after the date on which the examining board
625	625	initially granted the license.
626	626	(4) A person may substitute credit hours of college level courses related to the
627	627	practice of dental therapy for the credit hours required under sub. (1) (a). For
628	628	1
629	629	2
630	630	3
631	631	4
632	632	5
633	633	6
634	634	7
635	635	8
636	636	9
637	637	10
638	638	11
639	639	12
640	640	13
641	641	14
642	642	15
643	643	16
644	644	17
645	645	18
646	646	19
647	647	20
648	648	21
649	649	22
650	650	23
651	651	24
652	652	25 - 14 -2023 - 2024 Legislature LRB-5024/1
653	653	MED:cdc/wlj/skw
654	654	SECTION 37 ASSEMBLY BILL 668
655	655	purposes of this subsection, one credit hour of a college level course is equivalent to
656	656	6 credit hours of continuing education.
657	657	(5) For purposes of sub. (1) (a), one hour of teaching or preparing a continuing
658	658	education program is equivalent to one credit hour of continuing education, but a
659	659	person who teaches or prepares a continuing education program may obtain credit
660	660	for the program only once.
661	661	(6) The examining board may require applicants for renewal of a license to
662	662	practice dental therapy to submit proof of compliance with the requirements of this
663	663	section.
664	664	SECTION 38. 447.06 (1) of the statutes is amended to read:
665	665	447.06 (1) No contract of employment entered into between a dentist or dental
666	666	therapist and any other party under which the dentist or dental therapist renders
667	667	dental services may require the dentist or dental therapist to act in a manner which
668	668	that violates the professional standards for dentistry or dental therapy set forth in
669	669	this chapter. Nothing in this subsection limits the ability of the other party to control
670	670	the operation of the dental practice in a manner in accordance with the professional
671	671	standards for dentistry or dental therapy set forth in this chapter.
672	672	SECTION 39. 447.06 (1m) of the statutes is created to read:
673	673	447.06 (1m) No contract of employment entered into between a dental
674	674	therapist and any other party under which the dental therapist is employed to
675	675	practice dental therapy may require a dental therapist to meet a minimum quota for
676	676	the number of patients seen or the number of procedures performed.
677	677	SECTION 40. 447.06 (2) (a) 3. of the statutes is amended to read:
678	678	447.06 (2) (a) 3. For a school for the education of dentists, dental therapists,
679	679	or dental hygienists.
680	680	1
681	681	2
682	682	3
683	683	4
684	684	5
685	685	6
686	686	7
687	687	8
688	688	9
689	689	10
690	690	11
691	691	12
692	692	13
693	693	14
694	694	15
695	695	16
696	696	17
697	697	18
698	698	19
699	699	20
700	700	21
701	701	22
702	702	23
703	703	24
704	704	25 - 15 -2023 - 2024 Legislature
705	705	LRB-5024/1
706	706	MED:cdc/wlj/skw
707	707	SECTION 41
708	708	ASSEMBLY BILL 668
709	709	SECTION 41. 447.06 (2) (b) of the statutes is amended to read:
710	710	447.06 (2) (b) A dental hygienist may practice dental hygiene or perform
711	711	remediable procedures under par. (a) 1. only as authorized by a dentist or dental
712	712	therapist who is licensed to practice dentistry or dental therapy under this chapter
713	713	and who is present in the facility in which those practices or procedures are
714	714	performed, except as provided in par. (c).
715	715	SECTION 42. 447.06 (2) (c) (intro.) of the statutes is amended to read:
716	716	447.06 (2) (c) (intro.) A dental hygienist may practice dental hygiene or perform
717	717	remediable procedures under par. (a) 1. if a dentist or dental therapist who is licensed
718	718	to practice dentistry or dental therapy under this chapter is not present in the facility
719	719	in which those practices or procedures are performed only if all of the following
720	720	conditions are met:
721	721	SECTION 43. 447.06 (2) (c) 2. (intro.) of the statutes is amended to read:
722	722	447.06 (2) (c) 2. (intro.) The dentist or dental therapist who made the written
723	723	or oral prescription has examined the patient at least once during the 12-month
724	724	period immediately preceding:
725	725	SECTION 44. 447.06 (3) of the statutes is created to read:
726	726	447.06 (3) (a) In this subsection:
727	727	1. “Collaborative management agreement” means an agreement under par. (d).
728	728	2. “Dental health shortage area” has the meaning given in s. 36.60 (1) (ad).
729	729	3. “Direct supervision” means that the dentist is present in the dental office or
730	730	other practice setting, personally diagnoses the condition to be treated, personally
731	731	authorizes each procedure, and before dismissal of the patient, evaluates the
732	732	performance of the allied dental personnel.
733	733	1
734	734	2
735	735	3
736	736	4
737	737	5
738	738	6
739	739	7
740	740	8
741	741	9
742	742	10
743	743	11
744	744	12
745	745	13
746	746	14
747	747	15
748	748	16
749	749	17
750	750	18
751	751	19
752	752	20
753	753	21
754	754	22
755	755	23
756	756	24 - 16 -2023 - 2024 Legislature LRB-5024/1
757	757	MED:cdc/wlj/skw
758	758	SECTION 44 ASSEMBLY BILL 668
759	759	4. “General supervision” means that the dentist is not present in the dental
760	760	office or other practice setting or on the premises at the time tasks or procedures are
761	761	being performed by the dental therapist, but that the tasks or procedures performed
762	762	by the dental therapist are being performed with the prior knowledge and consent
763	763	of the dentist.
764	764	5. “Indirect supervision” means that the dentist is present in the dental office
765	765	or other practice setting, authorizes each procedure, and remains in the office while
766	766	the procedures are being performed by the allied dental personnel.
767	767	6. “Medical Assistance patient” means a patient who is a recipient of services
768	768	under the Medical Assistance program under subch. IV of ch. 49.
769	769	7. “Qualifying dentist” means a dentist who is licensed in this state, who is
770	770	actively practicing in this state, and who satisfies the requirement under par. (dr).
771	771	8. “Uninsured patient” means a patient who lacks dental health coverage,
772	772	either through a public health care program or private insurance, and has an annual
773	773	gross family income equal to or less than 200 percent of the federal poverty
774	774	guidelines.
775	775	(b) The scope of practice of a dental therapist shall, subject to the terms of a
776	776	collaborative management agreement, be limited to providing the following services,
777	777	treatments, and procedures:
778	778	1. Oral evaluation and assessment of dental disease and formulation of an
779	779	individualized treatment plan.
780	780	2. Identification of oral and systemic conditions requiring evaluation or
781	781	treatment by dentists, physicians, or other health care providers and managing
782	782	referrals.
783	783	3. Comprehensive charting of the oral cavity.
784	784	1
785	785	2
786	786	3
787	787	4
788	788	5
789	789	6
790	790	7
791	791	8
792	792	9
793	793	10
794	794	11
795	795	12
796	796	13
797	797	14
798	798	15
799	799	16
800	800	17
801	801	18
802	802	19
803	803	20
804	804	21
805	805	22
806	806	23
807	807	24
808	808	25 - 17 -2023 - 2024 Legislature
809	809	LRB-5024/1
810	810	MED:cdc/wlj/skw
811	811	SECTION 44
812	812	ASSEMBLY BILL 668
813	813	4. Oral health instruction and disease prevention education, including
814	814	nutritional counseling and dietary analysis.
815	815	5. Exposure and evaluation of radiographic images.
816	816	6. Dental prophylaxis, including subgingival scaling and polishing procedures.
817	817	7. Dispensing and administration via the oral or topical route of nonnarcotic
818	818	analgesic, anti-inflammatory, and antibiotic medications as prescribed by a licensed
819	819	health care provider.
820	820	8. Application of topical preventive or prophylactic agents, including fluoride
821	821	varnish, antimicrobial agents, caries arresting medicaments, and pit and fissure
822	822	sealants.
823	823	9. Pulp vitality testing.
824	824	10. Application of desensitizing medications or resins.
825	825	11. Fabrication of athletic mouth guards and soft occlusal guards.
826	826	12. Changing of periodontal dressings.
827	827	13. Administration of local anesthetic and nitrous oxide.
828	828	14. Simple extraction of erupted primary teeth.
829	829	15. Nonsurgical extraction of periodontally diseased permanent teeth with
830	830	tooth mobility of +3 to +4 to the extent authorized in the dental therapist's
831	831	collaborative management agreement, except for the extraction of a tooth that is
832	832	unerupted, impacted, or fractured or that needs to be sectioned for removal.
833	833	16. Emergency palliative treatment of dental pain limited to the procedures in
834	834	this paragraph.
835	835	17. Preparation and placement of direct restoration in primary and permanent
836	836	teeth.
837	837	18. Fabrication and placement of single-tooth temporary crowns.
838	838	1
839	839	2
840	840	3
841	841	4
842	842	5
843	843	6
844	844	7
845	845	8
846	846	9
847	847	10
848	848	11
849	849	12
850	850	13
851	851	14
852	852	15
853	853	16
854	854	17
855	855	18
856	856	19
857	857	20
858	858	21
859	859	22
860	860	23
861	861	24
862	862	25 - 18 -2023 - 2024 Legislature LRB-5024/1
863	863	MED:cdc/wlj/skw
864	864	SECTION 44 ASSEMBLY BILL 668
865	865	19. Preparation and placement of preformed crowns on primary teeth.
866	866	20. Indirect and direct pulp capping on permanent teeth.
867	867	21. Indirect pulp capping on primary teeth.
868	868	22. Intraoral suture placement and removal.
869	869	23. Minor adjustment and repair of removable prostheses.
870	870	24. Placement and removal of space maintainers.
871	871	25. Pulpotomy on primary teeth.
872	872	26. Tooth reimplantation and stabilization.
873	873	27. Recementing of a permanent crown.
874	874	28. Any additional services, treatments, or procedures specified in the rules
875	875	promulgated under s. 447.02 (1) (g).
876	876	(bm) 1. Notwithstanding par. (b) 1. to 28., a dental therapist shall, except as
877	877	provided in subd. 2., limit his or her practice of dental therapy to providing the
878	878	services, treatments, and procedures covered by his or her dental therapy education
879	879	program.
880	880	2. If any service, treatment, or procedure under par. (b) 1. to 28. was not covered
881	881	by a dental therapist's dental therapy education program, the dental therapist may
882	882	provide that service, treatment, or procedure if the dental therapist has
883	883	subsequently received additional dental therapy educational training to provide
884	884	that service, treatment, or procedure.
885	885	(c) 1. Except as provided in subd. 2., a dental therapist licensed under this
886	886	chapter may provide dental therapy services in this state only under the direct
887	887	supervision or indirect supervision of a qualifying dentist with whom the dental
888	888	therapist has entered into a collaborative management agreement.
889	889	1
890	890	2
891	891	3
892	892	4
893	893	5
894	894	6
895	895	7
896	896	8
897	897	9
898	898	10
899	899	11
900	900	12
901	901	13
902	902	14
903	903	15
904	904	16
905	905	17
906	906	18
907	907	19
908	908	20
909	909	21
910	910	22
911	911	23
912	912	24 - 19 -2023 - 2024 Legislature
913	913	LRB-5024/1
914	914	MED:cdc/wlj/skw
915	915	SECTION 44
916	916	ASSEMBLY BILL 668
917	917	2. a. Once a dental therapist licensed under this chapter has provided dental
918	918	therapy services for at least 2,000 hours under direct supervision or indirect
919	919	supervision, the dental therapist may provide dental therapy services in this state
920	920	under the general supervision of a qualifying dentist with whom the dental therapist
921	921	has entered into a collaborative management agreement.
922	922	b. For purposes of the 2,000 hours requirement under subd. 2. a., hours may
923	923	include hours of providing dental therapy services in this state under direct
924	924	supervision or indirect supervision of a qualifying dentist as described in subd. 1. or
925	925	hours of providing dental therapy services under direct supervision or indirect
926	926	supervision while licensed as a dental therapist outside this state, but may not
927	927	include any hours completed prior to graduating from the dental therapy education
928	928	program.
929	929	3. Notwithstanding subds. 1. and 2., the level of supervision for a dental
930	930	therapist may be further limited under the terms of a collaborative management
931	931	agreement under par. (d) 1. b.
932	932	4. A supervising dentist shall accept responsibility for all services performed
933	933	by a dental therapist pursuant to a collaborative management agreement. If services
934	934	needed by a patient are beyond the dental therapist's scope of practice or
935	935	authorization under the collaborative management agreement, the dental therapist
936	936	shall, to the extent required under the collaborative management agreement,
937	937	consult with the supervising dentist as needed to arrange for those services to be
938	938	provided by a dentist or another qualified health care provider.
939	939	(d) 1. Prior to providing any dental therapy services, a dental therapist shall
940	940	enter into a written collaborative management agreement with a qualifying dentist
941	941	1
942	942	2
943	943	3
944	944	4
945	945	5
946	946	6
947	947	7
948	948	8
949	949	9
950	950	10
951	951	11
952	952	12
953	953	13
954	954	14
955	955	15
956	956	16
957	957	17
958	958	18
959	959	19
960	960	20
961	961	21
962	962	22
963	963	23
964	964	24 - 20 -2023 - 2024 Legislature LRB-5024/1
965	965	MED:cdc/wlj/skw
966	966	SECTION 44 ASSEMBLY BILL 668
967	967	who will serve as a supervising dentist under par. (c). The agreement must be signed
968	968	by the dental therapist and the qualifying dentist and address all of the following:
969	969	a. The practice settings where services may be provided and the patient
970	970	populations that may be served.
971	971	b. Consistent with and subject to pars. (bm) and (c), any conditions or
972	972	limitations on the services that may be provided by the dental therapist, the level of
973	973	supervision required, and any circumstances requiring consultation prior to
974	974	performing services.
975	975	c. Age-specific and procedure-specific practice protocols.
976	976	d. Dental record-keeping procedures.
977	977	e. Plans for managing dental or medical emergencies.
978	978	f. A quality assurance plan for monitoring care provided by the dental
979	979	therapist.
980	980	g. Protocols for administering and dispensing medications.
981	981	h. Criteria or protocols relating to the provision of care to patients with specific
982	982	medical conditions, treatments, or medications.
983	983	i. Policies relating to supervision of dental hygienists and other staff.
984	984	j. A plan for the referral of patients to other dental or health care providers or
985	985	clinics when services needed are beyond the scope of practice or authorization of the
986	986	dental therapist.
987	987	k. Whether and to what extent the dental therapist may perform services
988	988	described in par. (b) 15.
989	989	2. a. A collaborative management agreement shall be limited to covering one
990	990	qualifying dentist and one dental therapist.
991	991	1
992	992	2
993	993	3
994	994	4
995	995	5
996	996	6
997	997	7
998	998	8
999	999	9
1000	1000	10
1001	1001	11
1002	1002	12
1003	1003	13
1004	1004	14
1005	1005	15
1006	1006	16
1007	1007	17
1008	1008	18
1009	1009	19
1010	1010	20
1011	1011	21
1012	1012	22
1013	1013	23
1014	1014	24 - 21 -2023 - 2024 Legislature
1015	1015	LRB-5024/1
1016	1016	MED:cdc/wlj/skw
1017	1017	SECTION 44
1018	1018	ASSEMBLY BILL 668
1019	1019	b. A dental therapist may enter into multiple collaborative management
1020	1020	agreements.
1021	1021	c. No dentist may have collaborative management agreements with more than
1022	1022	4 dental therapists at any time.
1023	1023	(dm) A dental therapist may, subject to par. (e), provide dental therapy services
1024	1024	only as an employee of one or more of the following that satisfies par. (dr):
1025	1025	1. A dentist with whom the dental therapist has entered into a collaborative
1026	1026	management agreement.
1027	1027	2. A dental practice.
1028	1028	3. A school district or the operator of a private school, as defined in s. 115.001
1029	1029	(3r), or a tribal school, as defined in s. 115.001 (15m).
1030	1030	4. The operator of a school for the education of dentists or dental hygienists.
1031	1031	5. A state or federal prison, a county jail, or other federal, state, county, or
1032	1032	municipal correctional or detention facility, or a facility established to provide care
1033	1033	for terminally ill patients.
1034	1034	6. A local health department, as defined in s. 250.01 (4).
1035	1035	7. A charitable institution open to the general public or to members of a
1036	1036	religious sect or order.
1037	1037	8. A nonprofit home health care agency.
1038	1038	9. The operator of a nonprofit dental care program serving primarily indigent,
1039	1039	economically disadvantaged, or migrant worker populations.
1040	1040	10. A health care employer, as defined in s. 440.094 (1) (b).
1041	1041	(dr) A dentist may not enter into a collaborative management agreement with
1042	1042	a dental therapist unless the dentist directly employs the dental therapist as
1043	1043	1
1044	1044	2
1045	1045	3
1046	1046	4
1047	1047	5
1048	1048	6
1049	1049	7
1050	1050	8
1051	1051	9
1052	1052	10
1053	1053	11
1054	1054	12
1055	1055	13
1056	1056	14
1057	1057	15
1058	1058	16
1059	1059	17
1060	1060	18
1061	1061	19
1062	1062	20
1063	1063	21
1064	1064	22
1065	1065	23
1066	1066	24 - 22 -2023 - 2024 Legislature LRB-5024/1
1067	1067	MED:cdc/wlj/skw
1068	1068	SECTION 44 ASSEMBLY BILL 668
1069	1069	provided in par. (dm) 1. or the dentist is employed by or contracts with the dental
1070	1070	therapist's employer described in par. (dm) 2. to 10.
1071	1071	(e) A dental therapist shall at all times comply with at least one of the following:
1072	1072	1. Limit his or her practice to practicing in one or more dental health shortage
1073	1073	areas. If a dental therapist begins practicing in a dental health shortage area, and
1074	1074	that area loses its designation as a dental health shortage area while the dental
1075	1075	therapist continues to practice in that area, the dental therapist is considered to
1076	1076	satisfy this subdivision as long as the dental therapist continues to practice in that
1077	1077	area.
1078	1078	2. Practice in one or more settings in which at least 50 percent of the total
1079	1079	patient base of the dental therapist consists of patients who are any of the following:
1080	1080	a. Medical Assistance patients.
1081	1081	b. Uninsured patients.
1082	1082	c. Patients receiving dental care at free and charitable clinics.
1083	1083	d. Patients receiving dental care at federally qualified health centers.
1084	1084	e. Patients who reside in long-term care facilities.
1085	1085	f. Veterans.
1086	1086	g. Patients who are members of a federally recognized Indian tribe or band.
1087	1087	h. Patients receiving dental care at clinics or facilities located on tribal lands.
1088	1088	i. Patients with medical disabilities or chronic conditions that create barriers
1089	1089	of access to dental care.
1090	1090	SECTION 45. 447.063 of the statutes is amended to read:
1091	1091	447.063 Preservation and transfer of patient health care records. (1)
1092	1092	A person who manages or controls a business that offers dental, dental therapy, or
1093	1093	dental hygiene services, including management or control of a business through
1094	1094	1
1095	1095	2
1096	1096	3
1097	1097	4
1098	1098	5
1099	1099	6
1100	1100	7
1101	1101	8
1102	1102	9
1103	1103	10
1104	1104	11
1105	1105	12
1106	1106	13
1107	1107	14
1108	1108	15
1109	1109	16
1110	1110	17
1111	1111	18
1112	1112	19
1113	1113	20
1114	1114	21
1115	1115	22
1116	1116	23
1117	1117	24
1118	1118	25 - 23 -2023 - 2024 Legislature
1119	1119	LRB-5024/1
1120	1120	MED:cdc/wlj/skw
1121	1121	SECTION 45
1122	1122	ASSEMBLY BILL 668
1123	1123	which the person allows another person to offer dental, dental therapy, or dental
1124	1124	hygiene services, shall preserve patient health care records, as defined in s. 146.81
1125	1125	(4), for an amount of time determined by the examining board by rule.
1126	1126	(2) A person who manages or controls a business that offers dental, dental
1127	1127	therapy, or dental hygiene services, including management or control of a business
1128	1128	through which the person allows another person to offer dental, dental therapy, or
1129	1129	dental hygiene services, shall, upon request of a patient or person authorized by the
1130	1130	patient, as defined in s. 146.81 (5), transfer the patient health care records, as
1131	1131	defined in s. 146.81 (4), of the patient to another person that the patient or person
1132	1132	authorized by the patient specifies to receive the patient health care records.
1133	1133	SECTION 46. 447.065 of the statutes is amended to read:
1134	1134	447.065 Delegation of remediable procedures and dental practices. (1)
1135	1135	A dentist or dental therapist who is licensed to practice dentistry under this chapter
1136	1136	may delegate to an individual who is not licensed under this chapter only the
1137	1137	performance of remediable procedures, and only if all of the following conditions are
1138	1138	met:
1139	1139	(a) The unlicensed individual performs the remediable procedures in
1140	1140	accordance with a treatment plan approved by the dentist or dental therapist.
1141	1141	(b) The dentist or dental therapist is on the premises when the unlicensed
1142	1142	individual performs the remediable procedures.
1143	1143	(c) The unlicensed individual's performance of the remediable procedures is
1144	1144	subject to inspection by the dentist or dental therapist.
1145	1145	(2) Subject to the requirements under s. 447.06 (2), a dentist or dental therapist
1146	1146	who is licensed to practice dentistry under this chapter may delegate to a dental
1147	1147	hygienist who is licensed to practice dental hygiene under this chapter the
1148	1148	1
1149	1149	2
1150	1150	3
1151	1151	4
1152	1152	5
1153	1153	6
1154	1154	7
1155	1155	8
1156	1156	9
1157	1157	10
1158	1158	11
1159	1159	12
1160	1160	13
1161	1161	14
1162	1162	15
1163	1163	16
1164	1164	17
1165	1165	18
1166	1166	19
1167	1167	20
1168	1168	21
1169	1169	22
1170	1170	23
1171	1171	24
1172	1172	25 - 24 -2023 - 2024 Legislature LRB-5024/1
1173	1173	MED:cdc/wlj/skw
1174	1174	SECTION 46 ASSEMBLY BILL 668
1175	1175	performance of remediable procedures and the administration of oral systemic
1176	1176	premedications, local anesthesia, nitrous oxide inhalation analgesia, and
1177	1177	subgingival sustained release chemotherapeutic agents, to the extent the dentist or
1178	1178	dental therapist has the authority to perform the activity personally.
1179	1179	(3) A dentist or dental therapist who delegates to another individual the
1180	1180	performance of any practice or remediable procedure is responsible for that
1181	1181	individual's performance of that delegated practice or procedure.
1182	1182	SECTION 47. 447.07 (1) of the statutes is amended to read:
1183	1183	447.07 (1) The examining board may, without further notice or process, limit,
1184	1184	suspend, or revoke the license or certificate of any dentist, dental therapist, or dental
1185	1185	hygienist, or the registration of a mobile dentistry program registrant, who fails,
1186	1186	within 60 days after the mailing of written notice to the dentist's, dental therapist's,
1187	1187	dental hygienist's, or registrant's last-known address, to renew the license,
1188	1188	certificate, or registration.
1189	1189	SECTION 48. 447.07 (3) (intro.) of the statutes is amended to read:
1190	1190	447.07 (3) (intro.) Subject to the rules promulgated under s. 440.03 (1), the
1191	1191	examining board may make investigations and conduct hearings in regard to any
1192	1192	alleged action of any dentist, dental therapist, dental hygienist, or expanded
1193	1193	function dental auxiliary, of a mobile dentistry program registrant, or of any other
1194	1194	person it has reason to believe is engaged in or has engaged in the practice of
1195	1195	dentistry, dental therapy, or dental hygiene, or the operation of a mobile dentistry
1196	1196	program, in this state, and may, on its own motion, or upon complaint in writing,
1197	1197	reprimand any dentist, dental therapist, dental hygienist, or expanded function
1198	1198	dental auxiliary who is licensed or certified under this chapter, or any mobile
1199	1199	dentistry program registrant, or deny, limit, suspend, or revoke his or her license or
1200	1200	1
1201	1201	2
1202	1202	3
1203	1203	4
1204	1204	5
1205	1205	6
1206	1206	7
1207	1207	8
1208	1208	9
1209	1209	10
1210	1210	11
1211	1211	12
1212	1212	13
1213	1213	14
1214	1214	15
1215	1215	16
1216	1216	17
1217	1217	18
1218	1218	19
1219	1219	20
1220	1220	21
1221	1221	22
1222	1222	23
1223	1223	24
1224	1224	25 - 25 -2023 - 2024 Legislature
1225	1225	LRB-5024/1
1226	1226	MED:cdc/wlj/skw
1227	1227	SECTION 48
1228	1228	ASSEMBLY BILL 668
1229	1229	certificate, or the registration of the mobile dentistry program registrant, if it finds
1230	1230	that the dentist, dental therapist, dental hygienist, expanded function dental
1231	1231	auxiliary, or mobile dentistry program registrant has done any of the following:
1232	1232	SECTION 49. 447.07 (3) (e) to (h) of the statutes are amended to read:
1233	1233	447.07 (3) (e) Subject to ss. 111.321, 111.322, and 111.335, been convicted of a
1234	1234	crime, the circumstances of which substantially relate to the practice of dentistry,
1235	1235	dental therapy, or dental hygiene, the practice of an expanded function dental
1236	1236	auxiliary, or the operation of a mobile dentistry program.
1237	1237	(f) Violated this chapter or any federal or state statute or rule that relates to
1238	1238	the practice of dentistry, dental therapy, dental hygiene, or an expanded function
1239	1239	dental auxiliary, or the operation of a mobile dentistry program.
1240	1240	(g) Subject to ss. 111.321, 111.322 and 111.34, practiced dentistry, dental
1241	1241	therapy, or dental hygiene or as an expanded function dental auxiliary while his or
1242	1242	her ability was impaired by alcohol or other drugs.
1243	1243	(h) Engaged in conduct that indicates a lack of knowledge of, an inability to
1244	1244	apply or the negligent application of, principles or skills of dentistry, dental therapy,
1245	1245	or dental hygiene or the practice of an expanded function dental auxiliary.
1246	1246	SECTION 50. 447.07 (6) of the statutes is created to read:
1247	1247	447.07 (6) The examining board shall immediately revoke the license to
1248	1248	practice dental therapy granted under s. 447.04 (1m) of an individual who qualified
1249	1249	for the license on the basis of graduation from a dental therapy education program
1250	1250	described in s. 447.04 (1m) (c) 3. if, upon the conclusion of the 4-year period described
1251	1251	in s. 447.04 (1m) (c) 3., the program is not accredited as described in s. 447.04 (1m)
1252	1252	(c) 1. If the program subsequently becomes accredited, the examining board may
1253	1253	allow reinstatement of a revoked license described in this subsection.
1254	1254	1
1255	1255	2
1256	1256	3
1257	1257	4
1258	1258	5
1259	1259	6
1260	1260	7
1261	1261	8
1262	1262	9
1263	1263	10
1264	1264	11
1265	1265	12
1266	1266	13
1267	1267	14
1268	1268	15
1269	1269	16
1270	1270	17
1271	1271	18
1272	1272	19
1273	1273	20
1274	1274	21
1275	1275	22
1276	1276	23
1277	1277	24
1278	1278	25 - 26 -2023 - 2024 Legislature LRB-5024/1
1279	1279	MED:cdc/wlj/skw
1280	1280	SECTION 51 ASSEMBLY BILL 668
1281	1281	SECTION 51. 447.40 (intro.) of the statutes is amended to read:
1282	1282	447.40 Informed consent. (intro.) Any dentist or dental therapist who treats
1283	1283	a patient shall inform the patient about the availability of reasonable alternate
1284	1284	modes of treatment and about the benefits and risks of these treatments. The
1285	1285	reasonable dentist standard is the standard for informing a patient under this
1286	1286	section. The reasonable dentist standard requires disclosure only of information
1287	1287	that a reasonable dentist would know and disclose under the circumstances. The
1288	1288	dentist's or dental therapist's duty to inform the patient under this section does not
1289	1289	require disclosure of any of the following:
1290	1290	SECTION 52. 447.40 (6) of the statutes is amended to read:
1291	1291	447.40 (6) Information about alternate modes of treatment for any condition
1292	1292	the dentist or dental therapist has not included in his or her diagnosis, assessment,
1293	1293	or treatment plan at the time the dentist or dental therapist informs the patient.
1294	1294	SECTION 53. 448.03 (2) (a) of the statutes is amended to read:
1295	1295	448.03 (2) (a) Any person lawfully practicing within the scope of a license,
1296	1296	permit, registration, certificate, or certification granted to practice midwifery under
1297	1297	subch. XIII of ch. 440, to practice professional or practical nursing or
1298	1298	nurse-midwifery under ch. 441, to practice chiropractic under ch. 446, to practice
1299	1299	dentistry, dental therapy, or dental hygiene or as an expanded function dental
1300	1300	auxiliary under ch. 447, to practice optometry under ch. 449, to practice as a
1301	1301	physician assistant under subch. IX, to practice acupuncture under ch. 451 or under
1302	1302	any other statutory provision, to practice naturopathic medicine under ch. 466, or as
1303	1303	otherwise provided by statute.
1304	1304	SECTION 54. 448.975 (2) (c) 1. of the statutes is amended to read:
1305	1305	1
1306	1306	2
1307	1307	3
1308	1308	4
1309	1309	5
1310	1310	6
1311	1311	7
1312	1312	8
1313	1313	9
1314	1314	10
1315	1315	11
1316	1316	12
1317	1317	13
1318	1318	14
1319	1319	15
1320	1320	16
1321	1321	17
1322	1322	18
1323	1323	19
1324	1324	20
1325	1325	21
1326	1326	22
1327	1327	23
1328	1328	24 - 27 -2023 - 2024 Legislature
1329	1329	LRB-5024/1
1330	1330	MED:cdc/wlj/skw
1331	1331	SECTION 54
1332	1332	ASSEMBLY BILL 668
1333	1333	448.975 (2) (c) 1. The practice of dentistry, dental therapy, or dental hygiene
1334	1334	within the meaning of ch. 447.
1335	1335	SECTION 55. 450.03 (1) (e) of the statutes is amended to read:
1336	1336	450.03 (1) (e) Any person lawfully practicing within the scope of a license,
1337	1337	permit, registration, certificate, or certification granted to practice as a pharmacy
1338	1338	technician under s. 450.068, to provide home medical oxygen under s. 450.076, to
1339	1339	practice professional or practical nursing or nurse-midwifery under ch. 441, to
1340	1340	practice dentistry, dental therapy, or dental hygiene or as an expanded function
1341	1341	dental auxiliary under ch. 447, to practice medicine and surgery under ch. 448, to
1342	1342	practice optometry under ch. 449, to practice naturopathic medicine under ch. 466,
1343	1343	or to practice veterinary medicine under ch. 89, or as otherwise provided by statute.
1344	1344	SECTION 56. 450.10 (3) (a) 4. of the statutes is amended to read:
1345	1345	450.10 (3) (a) 4. A dentist or dental therapist licensed under ch. 447.
1346	1346	SECTION 57. 462.02 (2) (d) of the statutes is amended to read:
1347	1347	462.02 (2) (d) A dentist licensed under s. 447.04 (1), a dental therapist licensed
1348	1348	under s. 447.04 (1m), a dental hygienist licensed under s. 447.04 (2), a person
1349	1349	certified as an expanded function dental auxiliary under s. 447.04 (3), or a person
1350	1350	under the direct supervision of a dentist.
1351	1351	SECTION 58. 462.04 of the statutes, as affected by 2021 Wisconsin Act 251, is
1352	1352	amended to read:
1353	1353	462.04 Prescription or order required. A person who holds a license or
1354	1354	limited X-ray machine operator permit under this chapter may not use diagnostic
1355	1355	X-ray equipment on humans for diagnostic purposes unless authorized to do so by
1356	1356	prescription or order of a physician licensed under s. 448.04 (1) (a), a naturopathic
1357	1357	doctor licensed under s. 466.04 (1), a dentist licensed under s. 447.04 (1), a dental
1358	1358	1
1359	1359	2
1360	1360	3
1361	1361	4
1362	1362	5
1363	1363	6
1364	1364	7
1365	1365	8
1366	1366	9
1367	1367	10
1368	1368	11
1369	1369	12
1370	1370	13
1371	1371	14
1372	1372	15
1373	1373	16
1374	1374	17
1375	1375	18
1376	1376	19
1377	1377	20
1378	1378	21
1379	1379	22
1380	1380	23
1381	1381	24
1382	1382	25 - 28 -2023 - 2024 Legislature LRB-5024/1
1383	1383	MED:cdc/wlj/skw
1384	1384	SECTION 58 ASSEMBLY BILL 668
1385	1385	therapist licensed under s. 447.04 (1m), a podiatrist licensed under s. 448.63, a
1386	1386	chiropractor licensed under s. 446.02, an advanced practice nurse certified under s.
1387	1387	441.16 (2), a physician assistant licensed under s. 448.974, or, subject to s. 448.56 (7)
1388	1388	(a), a physical therapist who is licensed under s. 448.53 or who holds a compact
1389	1389	privilege under subch. XI of ch. 448.
1390	1390	SECTION 59. 463.10 (5) of the statutes is amended to read:
1391	1391	463.10 (5) EXCEPTION. Subsections (2) to (4m) do not apply to a dentist who is
1392	1392	licensed under s. 447.03 (1) or to a , dental therapist, or physician who tattoos or
1393	1393	offers to tattoo a person in the course of the dentist's, dental therapist's, or physician's
1394	1394	professional practice.
1395	1395	SECTION 60. 463.12 (5) of the statutes is amended to read:
1396	1396	463.12 (5) EXCEPTION. Subsections (2) to (4m) do not apply to a dentist who is
1397	1397	licensed under s. 447.03 (1) or to a , dental therapist, or physician who pierces the
1398	1398	body of or offers to pierce the body of a person in the course of the dentist's, dental
1399	1399	therapist's, or physician's professional practice.
1400	1400	SECTION 61. 632.87 (4) of the statutes is amended to read:
1401	1401	632.87 (4) No policy, plan or contract may exclude coverage for diagnosis and
1402	1402	treatment of a condition or complaint by a licensed dentist or dental therapist within
1403	1403	the scope of the dentist's or dental therapist's license, if the policy, plan or contract
1404	1404	covers diagnosis and treatment of the condition or complaint by another health care
1405	1405	provider, as defined in s. 146.81 (1) (a) to (p).
1406	1406	SECTION 62. 895.48 (1m) (a) (intro.) of the statutes is amended to read:
1407	1407	895.48 (1m) (a) (intro.) Except as provided in par. (b), any physician,
1408	1408	naturopathic doctor, physician assistant, podiatrist, or athletic trainer licensed
1409	1409	under ch. 448, chiropractor licensed under ch. 446, dentist or dental therapist
1410	1410	1
1411	1411	2
1412	1412	3
1413	1413	4
1414	1414	5
1415	1415	6
1416	1416	7
1417	1417	8
1418	1418	9
1419	1419	10
1420	1420	11
1421	1421	12
1422	1422	13
1423	1423	14
1424	1424	15
1425	1425	16
1426	1426	17
1427	1427	18
1428	1428	19
1429	1429	20
1430	1430	21
1431	1431	22
1432	1432	23
1433	1433	24
1434	1434	25 - 29 -2023 - 2024 Legislature
1435	1435	LRB-5024/1
1436	1436	MED:cdc/wlj/skw
1437	1437	SECTION 62
1438	1438	ASSEMBLY BILL 668
1439	1439	licensed under ch. 447, emergency medical services practitioner licensed under s.
1440	1440	256.15, emergency medical responder certified under s. 256.15 (8), registered nurse
1441	1441	licensed under ch. 441, or a massage therapist or bodywork therapist licensed under
1442	1442	ch. 460 who renders voluntary health care to a participant in an athletic event or
1443	1443	contest sponsored by a nonprofit corporation, as defined in s. 66.0129 (6) (b), a private
1444	1444	school, as defined in s. 115.001 (3r), a tribal school, as defined in s. 115.001 (15m), a
1445	1445	public agency, as defined in s. 46.856 (1) (b), or a school, as defined in s. 609.655 (1)
1446	1446	(c), is immune from civil liability for his or her acts or omissions in rendering that
1447	1447	care if all of the following conditions exist:
1448	1448	SECTION 63. 895.48 (1m) (a) 2. of the statutes is amended to read:
1449	1449	895.48 (1m) (a) 2. The physician, naturopathic doctor, podiatrist, athletic
1450	1450	trainer, chiropractor, dentist, dental therapist, emergency medical services
1451	1451	practitioner, as defined in s. 256.01 (5), emergency medical responder, as defined in
1452	1452	s. 256.01 (4p), physician assistant, registered nurse, massage therapist or bodywork
1453	1453	therapist does not receive compensation for the health care, other than
1454	1454	reimbursement for expenses.
1455	1455	SECTION 64. 941.315 (5) of the statutes is amended to read:
1456	1456	941.315 (5) (a) Subsection (2) does not apply to a person to whom nitrous oxide
1457	1457	is administered for the purpose of providing medical or dental care, if the nitrous
1458	1458	oxide is administered by a physician or, dentist, or dental therapist or at the direction
1459	1459	or under the supervision of a physician or, dentist, or dental therapist.
1460	1460	(b) Subsection (3) does not apply to the administration of nitrous oxide by a
1461	1461	physician or, dentist, or dental therapist, or by another person at the direction or
1462	1462	under the supervision of a physician or, dentist, or dental therapist, for the purpose
1463	1463	of providing medical or dental care.
1464	1464	1
1465	1465	2
1466	1466	3
1467	1467	4
1468	1468	5
1469	1469	6
1470	1470	7
1471	1471	8
1472	1472	9
1473	1473	10
1474	1474	11
1475	1475	12
1476	1476	13
1477	1477	14
1478	1478	15
1479	1479	16
1480	1480	17
1481	1481	18
1482	1482	19
1483	1483	20
1484	1484	21
1485	1485	22
1486	1486	23
1487	1487	24
1488	1488	25 - 30 -2023 - 2024 Legislature LRB-5024/1
1489	1489	MED:cdc/wlj/skw
1490	1490	SECTION 64 ASSEMBLY BILL 668
1491	1491	(c) Subsection (3) (c) does not apply to the sale to a hospital, health care clinic
1492	1492	or other health care organization or to a physician or, dentist, or dental therapist of
1493	1493	any object used, designed for use or primarily intended for use in administering
1494	1494	nitrous oxide for the purpose of providing medical or dental care.
1495	1495	SECTION 65.0Nonstatutory provisions.
1496	1496	(1) The dentistry examining board shall send a notice to the legislative
1497	1497	reference bureau for publication in the Wisconsin Administrative Register when the
1498	1498	board determines that 50 or more individuals are currently licensed as dental
1499	1499	therapists in this state under s. 447.04 (1m).
1500	1500	(2) (a) The dentistry examining board shall promulgate emergency rules under
1501	1501	s. 227.24 that are necessary to implement this act. Notwithstanding s. 227.24 (1) (c)
1502	1502	and (2), emergency rules promulgated under this paragraph remain in effect for 2
1503	1503	years, or until the date on which permanent rules take effect, whichever is sooner.
1504	1504	Notwithstanding s. 227.24 (1) (a) and (3), the board is not required to provide
1505	1505	evidence that promulgating a rule under this paragraph as an emergency rule is
1506	1506	necessary for the preservation of the public peace, health, safety, or welfare and is
1507	1507	not required to provide a finding of emergency for a rule promulgated under this
1508	1508	paragraph.
1509	1509	(b) The dentistry examining board shall present a statement of scope for
1510	1510	permanent and emergency rules required to implement this act to the department
1511	1511	of administration under s. 227.135 (2) no later than the 30th day after the effective
1512	1512	date of this paragraph. Notwithstanding s. 227.135 (2), if the governor does not
1513	1513	disapprove the statement of scope by the 30th day after the statement is presented
1514	1514	to the department of administration, the statement is considered to be approved by
1515	1515	the governor.
1516	1516	1
1517	1517	2
1518	1518	3
1519	1519	4
1520	1520	5
1521	1521	6
1522	1522	7
1523	1523	8
1524	1524	9
1525	1525	10
1526	1526	11
1527	1527	12
1528	1528	13
1529	1529	14
1530	1530	15
1531	1531	16
1532	1532	17
1533	1533	18
1534	1534	19
1535	1535	20
1536	1536	21
1537	1537	22
1538	1538	23
1539	1539	24
1540	1540	25 - 31 -2023 - 2024 Legislature
1541	1541	LRB-5024/1
1542	1542	MED:cdc/wlj/skw
1543	1543	SECTION 65
1544	1544	ASSEMBLY BILL 668
1545	1545	(c) The dentistry examining board shall submit a proposed emergency rule
1546	1546	required to implement this act to the governor for approval under s. 227.24 (1) (e) 1g.
1547	1547	no later than the 150th day after the effective date of this paragraph.
1548	1548	Notwithstanding s. 227.24 (1) (e) 1g., if the governor does not reject the proposed
1549	1549	emergency rule by the 14th day after the rule is submitted to the governor in final
1550	1550	draft form, the rule is considered to be approved by the governor.
1551	1551	(d) The dentistry examining board shall submit a proposed permanent rule
1552	1552	required to implement this act to the governor for approval under s. 227.185 no later
1553	1553	than the 365th day after the effective date of this paragraph. Notwithstanding s.
1554	1554	227.185, if the governor does not reject that proposed permanent rule by the 30th day
1555	1555	after the rule is submitted to the governor in final draft form, the rule is considered
1556	1556	to be approved by the governor.
1557	1557	SECTION 66.0Effective dates. This act takes effect on the day after publication,
1558	1558	except as follows:
1559	1559	(1) The treatment of s. 15.405 (6) (b) takes effect on the date the notice under
1560	1560	s. 447.02 (6) is published in the Wisconsin Administrative Register or on the first day
1561	1561	of the 6th year beginning after publication, whichever occurs first.
1562	1562	(END)
1563	1563	1
1564	1564	2
1565	1565	3
1566	1566	4
1567	1567	5
1568	1568	6
1569	1569	7
1570	1570	8
1571	1571	9
1572	1572	10
1573	1573	11
1574	1574	12
1575	1575	13
1576	1576	14
1577	1577	15
1578	1578	16
1579	1579	17
1580	1580	18