Sen. Bill Cunningham

Filed: 2/21/2024

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 2586

2    AMENDMENT NO. ______. Amend Senate Bill 2586 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Dental Practice Act is amended by
5changing Sections 4, 18.1, and 23 and by adding Section 17.2 as
6follows:
 
7    (225 ILCS 25/4)
8    (Section scheduled to be repealed on January 1, 2026)
9    Sec. 4. Definitions. As used in this Act:
10    "Address of record" means the designated address recorded
11by the Department in the applicant's or licensee's application
12file or license file as maintained by the Department's
13licensure maintenance unit. It is the duty of the applicant or
14licensee to inform the Department of any change of address and
15those changes must be made either through the Department's
16website or by contacting the Department.

 

 

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1    "Department" means the Department of Financial and
2Professional Regulation.
3    "Secretary" means the Secretary of Financial and
4Professional Regulation.
5    "Board" means the Board of Dentistry.
6    "Dentist" means a person who has received a general
7license pursuant to paragraph (a) of Section 11 of this Act and
8who may perform any intraoral and extraoral procedure required
9in the practice of dentistry and to whom is reserved the
10responsibilities specified in Section 17.
11    "Dental hygienist" means a person who holds a license
12under this Act to perform dental services as authorized by
13Section 18.
14    "Dental assistant" means an appropriately trained person
15who, under the supervision of a dentist, provides dental
16services as authorized by Section 17.
17    "Expanded function dental assistant" means a dental
18assistant who has completed the training required by Section
1917.1 of this Act.
20    "Dental laboratory" means a person, firm, or corporation
21which:
22        (i) engages in making, providing, repairing, or
23    altering dental prosthetic appliances and other artificial
24    materials and devices which are returned to a dentist for
25    insertion into the human oral cavity or which come in
26    contact with its adjacent structures and tissues; and

 

 

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1        (ii) utilizes or employs a dental technician to
2    provide such services; and
3        (iii) performs such functions only for a dentist or
4    dentists.
5    "Supervision" means supervision of a dental hygienist or a
6dental assistant requiring that a dentist authorize the
7procedure, remain in the dental facility while the procedure
8is performed, and approve the work performed by the dental
9hygienist or dental assistant before dismissal of the patient,
10but does not mean that the dentist must be present at all times
11in the treatment room.
12    "General supervision" means supervision of a dental
13hygienist requiring that the patient be a patient of record,
14that the dentist examine the patient in accordance with
15Section 18 prior to treatment by the dental hygienist, and
16that the dentist authorize the procedures which are being
17carried out by a notation in the patient's record, but not
18requiring that a dentist be present when the authorized
19procedures are being performed. The issuance of a prescription
20to a dental laboratory by a dentist does not constitute
21general supervision.
22    "Public member" means a person who is not a health
23professional. For purposes of board membership, any person
24with a significant financial interest in a health service or
25profession is not a public member.
26    "Dentistry" means the healing art which is concerned with

 

 

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1the examination, diagnosis, treatment planning, and care of
2conditions within the human oral cavity and its adjacent
3tissues and structures, as further specified in Section 17.
4    "Branches of dentistry" means the various specialties of
5dentistry which, for purposes of this Act, shall be limited to
6the following: endodontics, oral and maxillofacial surgery,
7orthodontics and dentofacial orthopedics, pediatric dentistry,
8periodontics, prosthodontics, oral and maxillofacial
9radiology, and dental anesthesiology.
10    "Specialist" means a dentist who has received a specialty
11license pursuant to Section 11(b).
12    "Dental technician" means a person who owns, operates, or
13is employed by a dental laboratory and engages in making,
14providing, repairing, or altering dental prosthetic appliances
15and other artificial materials and devices which are returned
16to a dentist for insertion into the human oral cavity or which
17come in contact with its adjacent structures and tissues.
18    "Informed consent" means legally valid consent that is
19given by a patient or legal guardian, that is recorded in
20writing or digitally, that authorizes intervention or
21treatment services from the treating dentist, and that
22documents agreement to participate in those services and
23knowledge of the risks, benefits, and alternatives, including
24the decision to withdraw from or decline treatment.
25    "Impaired dentist" or "impaired dental hygienist" means a
26dentist or dental hygienist who is unable to practice with

 

 

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1reasonable skill and safety because of a physical or mental
2disability as evidenced by a written determination or written
3consent based on clinical evidence, including deterioration
4through the aging process, loss of motor skills, abuse of
5drugs or alcohol, or a psychiatric disorder, of sufficient
6degree to diminish the person's ability to deliver competent
7patient care.
8    "Nurse" means a registered professional nurse, a certified
9registered nurse anesthetist licensed as an advanced practice
10registered nurse, or a licensed practical nurse licensed under
11the Nurse Practice Act.
12    "Patient of record" means a patient for whom the patient's
13most recent dentist has obtained a relevant medical and dental
14history and on whom the dentist has performed a physical an
15examination within the last year and evaluated the condition
16to be treated, including a review of the patient's most recent
17x-rays.
18    "Dental responder" means a dentist or dental hygienist who
19is appropriately certified in disaster preparedness,
20immunizations, and dental humanitarian medical response
21consistent with the Society of Disaster Medicine and Public
22Health and training certified by the National Incident
23Management System or the National Disaster Life Support
24Foundation.
25    "Mobile dental van or portable dental unit" means any
26self-contained or portable dental unit in which dentistry is

 

 

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1practiced that can be moved, towed, or transported from one
2location to another in order to establish a location where
3dental services can be provided.
4    "Public health dental hygienist" means a hygienist who
5holds a valid license to practice in the State, has 2 years of
6full-time clinical experience or an equivalent of 4,000 hours
7of clinical experience, and has completed at least 42 clock
8hours of additional structured courses in dental education in
9advanced areas specific to public health dentistry.
10    "Public health setting" means a federally qualified health
11center; a federal, State, or local public health facility;
12Head Start; a special supplemental nutrition program for
13Women, Infants, and Children (WIC) facility; a certified
14school-based health center or school-based oral health
15program; a prison; or a long-term care facility.
16    "Public health supervision" means the supervision of a
17public health dental hygienist by a licensed dentist who has a
18written public health supervision agreement with that public
19health dental hygienist while working in an approved facility
20or program that allows the public health dental hygienist to
21treat patients, without a dentist first examining the patient
22and being present in the facility during treatment, (1) who
23are eligible for Medicaid or (2) who are uninsured or whose
24household income is not greater than 300% of the federal
25poverty level.
26    "Teledentistry" means the use of telehealth systems and

 

 

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1methodologies in dentistry and includes patient diagnosis,
2treatment planning, care, and education delivery for a patient
3of record using synchronous and asynchronous communications
4under an Illinois licensed a dentist's authority as provided
5under this Act.
6(Source: P.A. 102-93, eff. 1-1-22; 102-588, eff. 8-20-21;
7102-936, eff. 1-1-23; 103-425, eff. 1-1-24; 103-431, eff.
81-1-24; revised 12-15-23.)
 
9    (225 ILCS 25/17.2 new)
10    Sec. 17.2. Teledentistry. A dentist may only practice or
11utilize teledentistry on a patient of record. A dentist
12practicing dentistry through teledentistry is subject to the
13same standard of care and practice standards that are
14applicable to dental services provided in a clinic or office
15setting. A dentist may provide and delegate dental services
16using teledentistry only under the supervision requirements as
17specified in this Act for in-person care. Prior to providing
18teledentistry services to a patient, a dentist must obtain
19informed consent from the patient as to the treatment proposed
20to be offered through teledentistry by the dentist. It is a
21violation of this Act for a provider of dental services
22rendering care through teledentistry to require a patient to
23sign an agreement that limits in any way the patient's ability
24to write a review of services received or file a complaint with
25the Department or other regulatory agency. The Department

 

 

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1shall adopt rules to provide for the use of teledentistry in
2the State of Illinois.
 
3    (225 ILCS 25/18.1)
4    (Section scheduled to be repealed on January 1, 2026)
5    Sec. 18.1. Public health dental supervision
6responsibilities.
7    (a) When working together in a public health supervision
8relationship, dentists and public health dental hygienists
9shall enter into a public health supervision agreement. The
10dentist providing public health supervision must:
11        (1) be available to provide an appropriate level of
12    contact, communication, collaboration, and consultation
13    with the public health dental hygienist and must meet
14    in-person with the public health dental hygienist at least
15    quarterly for review and consultation;
16        (2) have specific standing orders or policy guidelines
17    for procedures that are to be carried out for each
18    location or program, although the dentist need not be
19    present when the procedures are being performed;
20        (3) provide for the patient's additional necessary
21    care in consultation with the public health dental
22    hygienist;
23        (4) file agreements and notifications as required; and
24        (5) include procedures for creating and maintaining
25    dental records, including protocols for transmission of

 

 

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1    all records between the public health dental hygienist and
2    the dentist following each treatment, which shall include
3    a notation regarding procedures authorized by the dentist
4    and performed by the public health dental hygienist and
5    the location where those records are to be kept.
6    Each dentist and hygienist who enters into a public health
7supervision agreement must document and maintain a copy of any
8change or termination of that agreement.
9    Dental records shall be owned and maintained by the
10supervising dentist for all patients treated under public
11health supervision, unless the supervising dentist is an
12employee of a public health clinic or federally qualified
13health center, in which case the public health clinic or
14federally qualified health center shall maintain the records.
15    If a dentist ceases to be employed or contracted by the
16facility, the dentist shall notify the facility administrator
17that the public health supervision agreement is no longer in
18effect. A new public health supervision agreement is required
19for the public health dental hygienist to continue treating
20patients under public health supervision.
21    A dentist entering into an agreement under this Section
22may supervise and enter into agreements for public health
23supervision with 4 public health dental hygienists. This shall
24be in addition to the limit of 4 dental hygienists per dentist
25set forth in subsection (g) of Section 18 of this Act.
26    (b) A public health dental hygienist providing services

 

 

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1under public health supervision may perform only those duties
2within the accepted scope of practice of dental hygiene, as
3follows:
4        (1) the operative procedures of dental hygiene,
5    consisting of oral prophylactic procedures, including
6    prophylactic cleanings, application of fluoride, and
7    placement of sealants;
8        (2) the exposure and processing of x-ray films of the
9    teeth and surrounding structures; and
10        (3) such other procedures and acts as shall be
11    prescribed by rule of the Department.
12    Any patient treated under this subsection (b) must be
13examined by a dentist before additional services can be
14provided by a public health dental hygienist. However, if the
15supervising dentist, after consultation with the public health
16hygienist, determines that time is needed to complete an
17approved treatment plan on a patient eligible under this
18Section, then the dentist may instruct the hygienist to
19complete the remaining services prior to an oral examination
20by the dentist. Such instruction by the dentist to the
21hygienist shall be noted in the patient's records. Any
22services performed under this exception must be scheduled in a
23timely manner and shall not occur more than 30 days after the
24first appointment date.
25    (c) A public health dental hygienist providing services
26under public health supervision must:

 

 

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1        (1) provide to the patient, parent, or guardian a
2    written plan for referral or an agreement for follow-up
3    that records all conditions observed that should be called
4    to the attention of a dentist for proper diagnosis;
5        (2) have each patient sign a permission slip or
6    consent form that informs them that the service to be
7    received does not take the place of regular dental
8    checkups at a dental office and is meant for people who
9    otherwise would not have access to the service;
10        (3) inform each patient who may require further dental
11    services of that need;
12        (4) maintain an appropriate level of contact and
13    communication with the dentist providing public health
14    supervision; and
15        (5) complete an additional 4 hours of continuing
16    education in areas specific to public health dentistry
17    yearly.
18    (d) Each public health dental hygienist who has rendered
19services under subsections (c), (d), and (e) of this Section
20must complete a summary report at the completion of a program
21or, in the case of an ongoing program, at least annually. The
22report must be completed in the manner specified by the
23Department of Public Health Oral Health Section including
24information about each location where the public health dental
25hygienist has rendered these services. The public health
26dental hygienist must submit the form to the dentist providing

 

 

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1supervision for his or her signature before sending it to the
2Division. The Department of Public Health Oral Health Section
3shall compile and publicize public health dental hygienist
4service data annually.
5    (e) Public health dental hygienists providing services
6under public health supervision may be compensated for their
7work by salary, honoraria, and other mechanisms by the
8employing or sponsoring entity. Nothing in this Act shall
9preclude the entity that employs or sponsors a public health
10dental hygienist from seeking payment, reimbursement, or other
11source of funding for the services provided.
12    (e-5) A patient who is provided services under a
13supervision agreement by a public health dental hygienist as
14described in this Section does not need to receive a physical
15examination from a dentist prior to treatment if the public
16health dental hygienist consults with the supervising dentist
17prior to performing the teledentistry service.
18    (f) This Section is repealed on January 1, 2026.
19(Source: P.A. 103-431, eff. 1-1-24.)
 
20    (225 ILCS 25/23)  (from Ch. 111, par. 2323)
21    (Section scheduled to be repealed on January 1, 2026)
22    Sec. 23. Refusal, revocation or suspension of dental
23licenses. The Department may refuse to issue or renew, or may
24revoke, suspend, place on probation, reprimand or take other
25disciplinary or non-disciplinary action as the Department may

 

 

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1deem proper, including imposing fines not to exceed $10,000
2per violation, with regard to any license for any one or any
3combination of the following causes:
4        1. Fraud or misrepresentation in applying for or
5    procuring a license under this Act, or in connection with
6    applying for renewal of a license under this Act.
7        2. Inability to practice with reasonable judgment,
8    skill, or safety as a result of habitual or excessive use
9    or addiction to alcohol, narcotics, stimulants, or any
10    other chemical agent or drug.
11        3. Willful or repeated violations of the rules of the
12    Department of Public Health or Department of Nuclear
13    Safety.
14        4. Acceptance of a fee for service as a witness,
15    without the knowledge of the court, in addition to the fee
16    allowed by the court.
17        5. Division of fees or agreeing to split or divide the
18    fees received for dental services with any person for
19    bringing or referring a patient, except in regard to
20    referral services as provided for under Section 45, or
21    assisting in the care or treatment of a patient, without
22    the knowledge of the patient or his or her legal
23    representative. Nothing in this item 5 affects any bona
24    fide independent contractor or employment arrangements
25    among health care professionals, health facilities, health
26    care providers, or other entities, except as otherwise

 

 

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1    prohibited by law. Any employment arrangements may include
2    provisions for compensation, health insurance, pension, or
3    other employment benefits for the provision of services
4    within the scope of the licensee's practice under this
5    Act. Nothing in this item 5 shall be construed to require
6    an employment arrangement to receive professional fees for
7    services rendered.
8        6. Employing, procuring, inducing, aiding or abetting
9    a person not licensed or registered as a dentist or dental
10    hygienist to engage in the practice of dentistry or dental
11    hygiene. The person practiced upon is not an accomplice,
12    employer, procurer, inducer, aider, or abetter within the
13    meaning of this Act.
14        7. Making any misrepresentations or false promises,
15    directly or indirectly, to influence, persuade or induce
16    dental patronage.
17        8. Professional connection or association with or
18    lending his or her name to another for the illegal
19    practice of dentistry by another, or professional
20    connection or association with any person, firm or
21    corporation holding himself, herself, themselves, or
22    itself out in any manner contrary to this Act.
23        9. Obtaining or seeking to obtain practice, money, or
24    any other things of value by false or fraudulent
25    representations, but not limited to, engaging in such
26    fraudulent practice to defraud the medical assistance

 

 

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1    program of the Department of Healthcare and Family
2    Services (formerly Department of Public Aid) under the
3    Illinois Public Aid Code.
4        10. Practicing under a false or, except as provided by
5    law, an assumed name.
6        11. Engaging in dishonorable, unethical, or
7    unprofessional conduct of a character likely to deceive,
8    defraud, or harm the public.
9        12. Conviction by plea of guilty or nolo contendere,
10    finding of guilt, jury verdict, or entry of judgment or by
11    sentencing for any crime, including, but not limited to,
12    convictions, preceding sentences of supervision,
13    conditional discharge, or first offender probation, under
14    the laws of any jurisdiction of the United States that (i)
15    is a felony under the laws of this State or (ii) is a
16    misdemeanor, an essential element of which is dishonesty,
17    or that is directly related to the practice of dentistry.
18        13. Permitting a dental hygienist, dental assistant or
19    other person under his or her supervision to perform any
20    operation not authorized by this Act.
21        14. Permitting more than 4 dental hygienists to be
22    employed under his or her supervision at any one time.
23        15. A violation of any provision of this Act or any
24    rules promulgated under this Act.
25        16. Taking impressions for or using the services of
26    any person, firm or corporation violating this Act.

 

 

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1        17. Violating any provision of Section 45 relating to
2    advertising.
3        18. Discipline by another U.S. jurisdiction or foreign
4    nation, if at least one of the grounds for the discipline
5    is the same or substantially equivalent to those set forth
6    within this Act.
7        19. Willfully failing to report an instance of
8    suspected child abuse or neglect as required by the Abused
9    and Neglected Child Reporting Act.
10        20. Gross negligence in practice under this Act.
11        21. The use or prescription for use of narcotics or
12    controlled substances or designated products as listed in
13    the Illinois Controlled Substances Act, in any way other
14    than for therapeutic purposes.
15        22. Willfully making or filing false records or
16    reports in his or her practice as a dentist, including,
17    but not limited to, false records to support claims
18    against the dental assistance program of the Department of
19    Healthcare and Family Services (formerly Illinois
20    Department of Public Aid).
21        23. Professional incompetence as manifested by poor
22    standards of care.
23        24. Physical or mental illness, including, but not
24    limited to, deterioration through the aging process, or
25    loss of motor skills which results in a dentist's
26    inability to practice dentistry with reasonable judgment,

 

 

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1    skill or safety. In enforcing this paragraph, the
2    Department may compel a person licensed to practice under
3    this Act to submit to a mental or physical examination
4    pursuant to the terms and conditions of Section 23b.
5        25. Gross or repeated irregularities in billing for
6    services rendered to a patient. For purposes of this
7    paragraph 25, "irregularities in billing" shall include:
8            (a) Reporting excessive charges for the purpose of
9        obtaining a total payment in excess of that usually
10        received by the dentist for the services rendered.
11            (b) Reporting charges for services not rendered.
12            (c) Incorrectly reporting services rendered for
13        the purpose of obtaining payment not earned.
14        26. Continuing the active practice of dentistry while
15    knowingly having any infectious, communicable, or
16    contagious disease proscribed by rule or regulation of the
17    Department.
18        27. Being named as a perpetrator in an indicated
19    report by the Department of Children and Family Services
20    pursuant to the Abused and Neglected Child Reporting Act,
21    and upon proof by clear and convincing evidence that the
22    licensee has caused a child to be an abused child or
23    neglected child as defined in the Abused and Neglected
24    Child Reporting Act.
25        28. Violating the Health Care Worker Self-Referral
26    Act.

 

 

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1        29. Abandonment of a patient.
2        30. Mental incompetency as declared by a court of
3    competent jurisdiction.
4        31. A finding by the Department that the licensee,
5    after having his or her license placed on probationary
6    status, has violated the terms of probation.
7        32. Material misstatement in furnishing information to
8    the Department.
9        33. Failing, within 60 days, to provide information in
10    response to a written request by the Department in the
11    course of an investigation.
12        34. Immoral conduct in the commission of any act,
13    including, but not limited to, commission of an act of
14    sexual misconduct related to the licensee's practice.
15        35. Cheating on or attempting to subvert the licensing
16    examination administered under this Act.
17        36. A pattern of practice or other behavior that
18    demonstrates incapacity or incompetence to practice under
19    this Act.
20        37. Failure to establish and maintain records of
21    patient care and treatment as required under this Act.
22        38. Failure to provide copies of dental records as
23    required by law.
24        39. Failure of a licensed dentist who owns or is
25    employed at a dental office to give notice of an office
26    closure to his or her patients at least 30 days prior to

 

 

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1    the office closure pursuant to Section 50.1.
2        40. Failure to maintain a sanitary work environment.
3        41. Failure to comply with the provisions of Section
4    17.2 of this Act.
5    All proceedings to suspend, revoke, place on probationary
6status, or take any other disciplinary action as the
7Department may deem proper, with regard to a license on any of
8the foregoing grounds, must be commenced within 5 years after
9receipt by the Department of a complaint alleging the
10commission of or notice of the conviction order for any of the
11acts described herein. Except for fraud in procuring a
12license, no action shall be commenced more than 7 years after
13the date of the incident or act alleged to have violated this
14Section. The time during which the holder of the license was
15outside the State of Illinois shall not be included within any
16period of time limiting the commencement of disciplinary
17action by the Department.
18    All fines imposed under this Section shall be paid within
1960 days after the effective date of the order imposing the fine
20or in accordance with the terms set forth in the order imposing
21the fine.
22    The Department may refuse to issue or may suspend the
23license of any person who fails to file a return, or to pay the
24tax, penalty or interest shown in a filed return, or to pay any
25final assessment of tax, penalty or interest, as required by
26any tax Act administered by the Illinois Department of

 

 

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1Revenue, until such time as the requirements of any such tax
2Act are satisfied.
3    Any dentist who has had his or her license suspended or
4revoked for more than 5 years must comply with the
5requirements for restoration set forth in Section 16 prior to
6being eligible for reinstatement from the suspension or
7revocation.
8(Source: P.A. 103-425, eff. 1-1-24.)
 
9    Section 10. The Consumer Fraud and Deceptive Business
10Practices Act is amended by adding Section 2EEEE as follows:
 
11    (815 ILCS 505/2EEEE new)
12    Sec. 2EEEE. Violations concerning teledentistry under the
13Illinois Dental Practice Act. Any person who violates Section
1417.2 of the Illinois Dental Practice Act commits an unlawful
15practice within the meaning of this Act.
 
16    Section 99. Effective date. This Act takes effect upon
17becoming law.".