Sen. Bill Cunningham

Filed: 4/9/2024

 

 


 

 


 
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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8    (Section scheduled to be repealed on January 1, 2026)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", except as provided in Section 17.2,
13means a patient for whom the patient's most recent dentist has
14obtained a relevant medical and dental history and on whom the
15dentist has performed a physical an examination within the
16last year and evaluated the condition to be treated, including
17a review of the patient's most recent x-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.
11    (a) As used in this Section, "patient of record" means a
12patient for whom the patient's most recent Illinois-licensed
13dentist has obtained a relevant medical and dental history and
14on whom the dentist has (i) performed a physical examination
15within the last year or (ii) obtained records from an
16in-person examination within the previous 12 months which
17evaluated the condition to be treated, including a review of
18the patient's most recent x-rays.
19    (b) A dentist may only practice or utilize teledentistry
20on a patient of record. A dentist practicing dentistry through
21teledentistry is subject to the same standard of care and
22practice standards that are applicable to dental services
23provided in a clinic or office setting. A dentist may provide
24and delegate dental services using teledentistry only under
25the supervision requirements as specified in this Act for

 

 

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1in-person care. Prior to providing teledentistry services to a
2patient, a dentist must obtain informed consent from the
3patient as to the treatment proposed to be offered through
4teledentistry by the dentist. A dentist providing
5teledentistry under this Section shall provide the patient
6with the his or her name, direct telephone number, and
7physical practice address. It is a violation of this Act for a
8provider of dental services rendering care through
9teledentistry to require a patient to sign an agreement that
10limits in any way the patient's ability to write a review of
11services received or file a complaint with the Department or
12other regulatory agency. A dentist may treat a patient through
13teledentistry in the absence of a provider-patient
14relationship when, in the professional judgment of the
15dentist, dental or medical emergency care is required. The
16Department shall adopt rules to provide for the use of
17teledentistry in the State of Illinois.
 
18    (225 ILCS 25/18.1)
19    (Section scheduled to be repealed on January 1, 2026)
20    Sec. 18.1. Public health dental supervision
21responsibilities.
22    (a) When working together in a public health supervision
23relationship, dentists and public health dental hygienists
24shall enter into a public health supervision agreement. The
25dentist providing public health supervision must:

 

 

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1        (1) be available to provide an appropriate level of
2    contact, communication, collaboration, and consultation
3    with the public health dental hygienist and must meet
4    in-person with the public health dental hygienist at least
5    quarterly for review and consultation;
6        (2) have specific standing orders or policy guidelines
7    for procedures that are to be carried out for each
8    location or program, although the dentist need not be
9    present when the procedures are being performed;
10        (3) provide for the patient's additional necessary
11    care in consultation with the public health dental
12    hygienist;
13        (4) file agreements and notifications as required; and
14        (5) include procedures for creating and maintaining
15    dental records, including protocols for transmission of
16    all records between the public health dental hygienist and
17    the dentist following each treatment, which shall include
18    a notation regarding procedures authorized by the dentist
19    and performed by the public health dental hygienist and
20    the location where those records are to be kept.
21    Each dentist and hygienist who enters into a public health
22supervision agreement must document and maintain a copy of any
23change or termination of that agreement.
24    Dental records shall be owned and maintained by the
25supervising dentist for all patients treated under public
26health supervision, unless the supervising dentist is an

 

 

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1employee of a public health clinic or federally qualified
2health center, in which case the public health clinic or
3federally qualified health center shall maintain the records.
4    If a dentist ceases to be employed or contracted by the
5facility, the dentist shall notify the facility administrator
6that the public health supervision agreement is no longer in
7effect. A new public health supervision agreement is required
8for the public health dental hygienist to continue treating
9patients under public health supervision.
10    A dentist entering into an agreement under this Section
11may supervise and enter into agreements for public health
12supervision with 4 public health dental hygienists. This shall
13be in addition to the limit of 4 dental hygienists per dentist
14set forth in subsection (g) of Section 18 of this Act.
15    (b) A public health dental hygienist providing services
16under public health supervision may perform only those duties
17within the accepted scope of practice of dental hygiene, as
18follows:
19        (1) the operative procedures of dental hygiene,
20    consisting of oral prophylactic procedures, including
21    prophylactic cleanings, application of fluoride, and
22    placement of sealants;
23        (2) the exposure and processing of x-ray films of the
24    teeth and surrounding structures; and
25        (3) such other procedures and acts as shall be
26    prescribed by rule of the Department.

 

 

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1    Any patient treated under this subsection (b) must be
2examined by a dentist before additional services can be
3provided by a public health dental hygienist. However, if the
4supervising dentist, after consultation with the public health
5hygienist, determines that time is needed to complete an
6approved treatment plan on a patient eligible under this
7Section, then the dentist may instruct the hygienist to
8complete the remaining services prior to an oral examination
9by the dentist. Such instruction by the dentist to the
10hygienist shall be noted in the patient's records. Any
11services performed under this exception must be scheduled in a
12timely manner and shall not occur more than 30 days after the
13first appointment date.
14    (c) A public health dental hygienist providing services
15under public health supervision must:
16        (1) provide to the patient, parent, or guardian a
17    written plan for referral or an agreement for follow-up
18    that records all conditions observed that should be called
19    to the attention of a dentist for proper diagnosis;
20        (2) have each patient sign a permission slip or
21    consent form that informs them that the service to be
22    received does not take the place of regular dental
23    checkups at a dental office and is meant for people who
24    otherwise would not have access to the service;
25        (3) inform each patient who may require further dental
26    services of that need;

 

 

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1        (4) maintain an appropriate level of contact and
2    communication with the dentist providing public health
3    supervision; and
4        (5) complete an additional 4 hours of continuing
5    education in areas specific to public health dentistry
6    yearly.
7    (d) Each public health dental hygienist who has rendered
8services under subsections (c), (d), and (e) of this Section
9must complete a summary report at the completion of a program
10or, in the case of an ongoing program, at least annually. The
11report must be completed in the manner specified by the
12Department of Public Health Oral Health Section including
13information about each location where the public health dental
14hygienist has rendered these services. The public health
15dental hygienist must submit the form to the dentist providing
16supervision for his or her signature before sending it to the
17Division. The Department of Public Health Oral Health Section
18shall compile and publicize public health dental hygienist
19service data annually.
20    (e) Public health dental hygienists providing services
21under public health supervision may be compensated for their
22work by salary, honoraria, and other mechanisms by the
23employing or sponsoring entity. Nothing in this Act shall
24preclude the entity that employs or sponsors a public health
25dental hygienist from seeking payment, reimbursement, or other
26source of funding for the services provided.

 

 

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1    (e-5) A patient who is provided services under a
2supervision agreement by a public health dental hygienist as
3described in this Section does not need to receive a physical
4examination from a dentist prior to treatment if the public
5health dental hygienist consults with the supervising dentist
6prior to performing the teledentistry service.
7    (f) This Section is repealed on January 1, 2026.
8(Source: P.A. 103-431, eff. 1-1-24.)
 
9    (225 ILCS 25/23)  (from Ch. 111, par. 2323)
10    (Section scheduled to be repealed on January 1, 2026)
11    Sec. 23. Refusal, revocation or suspension of dental
12licenses. The Department may refuse to issue or renew, or may
13revoke, suspend, place on probation, reprimand or take other
14disciplinary or non-disciplinary action as the Department may
15deem proper, including imposing fines not to exceed $10,000
16per violation, with regard to any license for any one or any
17combination of the following causes:
18        1. Fraud or misrepresentation in applying for or
19    procuring a license under this Act, or in connection with
20    applying for renewal of a license under this Act.
21        2. Inability to practice with reasonable judgment,
22    skill, or safety as a result of habitual or excessive use
23    or addiction to alcohol, narcotics, stimulants, or any
24    other chemical agent or drug.
25        3. Willful or repeated violations of the rules of the

 

 

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1    Department of Public Health or Department of Nuclear
2    Safety.
3        4. Acceptance of a fee for service as a witness,
4    without the knowledge of the court, in addition to the fee
5    allowed by the court.
6        5. Division of fees or agreeing to split or divide the
7    fees received for dental services with any person for
8    bringing or referring a patient, except in regard to
9    referral services as provided for under Section 45, or
10    assisting in the care or treatment of a patient, without
11    the knowledge of the patient or his or her legal
12    representative. Nothing in this item 5 affects any bona
13    fide independent contractor or employment arrangements
14    among health care professionals, health facilities, health
15    care providers, or other entities, except as otherwise
16    prohibited by law. Any employment arrangements may include
17    provisions for compensation, health insurance, pension, or
18    other employment benefits for the provision of services
19    within the scope of the licensee's practice under this
20    Act. Nothing in this item 5 shall be construed to require
21    an employment arrangement to receive professional fees for
22    services rendered.
23        6. Employing, procuring, inducing, aiding or abetting
24    a person not licensed or registered as a dentist or dental
25    hygienist to engage in the practice of dentistry or dental
26    hygiene. The person practiced upon is not an accomplice,

 

 

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1    employer, procurer, inducer, aider, or abetter within the
2    meaning of this Act.
3        7. Making any misrepresentations or false promises,
4    directly or indirectly, to influence, persuade or induce
5    dental patronage.
6        8. Professional connection or association with or
7    lending his or her name to another for the illegal
8    practice of dentistry by another, or professional
9    connection or association with any person, firm or
10    corporation holding himself, herself, themselves, or
11    itself out in any manner contrary to this Act.
12        9. Obtaining or seeking to obtain practice, money, or
13    any other things of value by false or fraudulent
14    representations, but not limited to, engaging in such
15    fraudulent practice to defraud the medical assistance
16    program of the Department of Healthcare and Family
17    Services (formerly Department of Public Aid) under the
18    Illinois Public Aid Code.
19        10. Practicing under a false or, except as provided by
20    law, an assumed name.
21        11. Engaging in dishonorable, unethical, or
22    unprofessional conduct of a character likely to deceive,
23    defraud, or harm the public.
24        12. Conviction by plea of guilty or nolo contendere,
25    finding of guilt, jury verdict, or entry of judgment or by
26    sentencing for any crime, including, but not limited to,

 

 

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1    convictions, preceding sentences of supervision,
2    conditional discharge, or first offender probation, under
3    the laws of any jurisdiction of the United States that (i)
4    is a felony under the laws of this State or (ii) is a
5    misdemeanor, an essential element of which is dishonesty,
6    or that is directly related to the practice of dentistry.
7        13. Permitting a dental hygienist, dental assistant or
8    other person under his or her supervision to perform any
9    operation not authorized by this Act.
10        14. Permitting more than 4 dental hygienists to be
11    employed under his or her supervision at any one time.
12        15. A violation of any provision of this Act or any
13    rules promulgated under this Act.
14        16. Taking impressions for or using the services of
15    any person, firm or corporation violating this Act.
16        17. Violating any provision of Section 45 relating to
17    advertising.
18        18. Discipline by another U.S. jurisdiction or foreign
19    nation, if at least one of the grounds for the discipline
20    is the same or substantially equivalent to those set forth
21    within this Act.
22        19. Willfully failing to report an instance of
23    suspected child abuse or neglect as required by the Abused
24    and Neglected Child Reporting Act.
25        20. Gross negligence in practice under this Act.
26        21. The use or prescription for use of narcotics or

 

 

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1    controlled substances or designated products as listed in
2    the Illinois Controlled Substances Act, in any way other
3    than for therapeutic purposes.
4        22. Willfully making or filing false records or
5    reports in his or her practice as a dentist, including,
6    but not limited to, false records to support claims
7    against the dental assistance program of the Department of
8    Healthcare and Family Services (formerly Illinois
9    Department of Public Aid).
10        23. Professional incompetence as manifested by poor
11    standards of care.
12        24. Physical or mental illness, including, but not
13    limited to, deterioration through the aging process, or
14    loss of motor skills which results in a dentist's
15    inability to practice dentistry with reasonable judgment,
16    skill or safety. In enforcing this paragraph, the
17    Department may compel a person licensed to practice under
18    this Act to submit to a mental or physical examination
19    pursuant to the terms and conditions of Section 23b.
20        25. Gross or repeated irregularities in billing for
21    services rendered to a patient. For purposes of this
22    paragraph 25, "irregularities in billing" shall include:
23            (a) Reporting excessive charges for the purpose of
24        obtaining a total payment in excess of that usually
25        received by the dentist for the services rendered.
26            (b) Reporting charges for services not rendered.

 

 

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1            (c) Incorrectly reporting services rendered for
2        the purpose of obtaining payment not earned.
3        26. Continuing the active practice of dentistry while
4    knowingly having any infectious, communicable, or
5    contagious disease proscribed by rule or regulation of the
6    Department.
7        27. Being named as a perpetrator in an indicated
8    report by the Department of Children and Family Services
9    pursuant to the Abused and Neglected Child Reporting Act,
10    and upon proof by clear and convincing evidence that the
11    licensee has caused a child to be an abused child or
12    neglected child as defined in the Abused and Neglected
13    Child Reporting Act.
14        28. Violating the Health Care Worker Self-Referral
15    Act.
16        29. Abandonment of a patient.
17        30. Mental incompetency as declared by a court of
18    competent jurisdiction.
19        31. A finding by the Department that the licensee,
20    after having his or her license placed on probationary
21    status, has violated the terms of probation.
22        32. Material misstatement in furnishing information to
23    the Department.
24        33. Failing, within 60 days, to provide information in
25    response to a written request by the Department in the
26    course of an investigation.

 

 

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1        34. Immoral conduct in the commission of any act,
2    including, but not limited to, commission of an act of
3    sexual misconduct related to the licensee's practice.
4        35. Cheating on or attempting to subvert the licensing
5    examination administered under this Act.
6        36. A pattern of practice or other behavior that
7    demonstrates incapacity or incompetence to practice under
8    this Act.
9        37. Failure to establish and maintain records of
10    patient care and treatment as required under this Act.
11        38. Failure to provide copies of dental records as
12    required by law.
13        39. Failure of a licensed dentist who owns or is
14    employed at a dental office to give notice of an office
15    closure to his or her patients at least 30 days prior to
16    the office closure pursuant to Section 50.1.
17        40. Failure to maintain a sanitary work environment.
18        41. Failure to comply with the provisions of Section
19    17.2 of this Act.
20    All proceedings to suspend, revoke, place on probationary
21status, or take any other disciplinary action as the
22Department may deem proper, with regard to a license on any of
23the foregoing grounds, must be commenced within 5 years after
24receipt by the Department of a complaint alleging the
25commission of or notice of the conviction order for any of the
26acts described herein. Except for fraud in procuring a

 

 

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1license, no action shall be commenced more than 7 years after
2the date of the incident or act alleged to have violated this
3Section. The time during which the holder of the license was
4outside the State of Illinois shall not be included within any
5period of time limiting the commencement of disciplinary
6action by the Department.
7    All fines imposed under this Section shall be paid within
860 days after the effective date of the order imposing the fine
9or in accordance with the terms set forth in the order imposing
10the fine.
11    The Department may refuse to issue or may suspend the
12license of any person who fails to file a return, or to pay the
13tax, penalty or interest shown in a filed return, or to pay any
14final assessment of tax, penalty or interest, as required by
15any tax Act administered by the Illinois Department of
16Revenue, until such time as the requirements of any such tax
17Act are satisfied.
18    Any dentist who has had his or her license suspended or
19revoked for more than 5 years must comply with the
20requirements for restoration set forth in Section 16 prior to
21being eligible for reinstatement from the suspension or
22revocation.
23(Source: P.A. 103-425, eff. 1-1-24.)
 
24    Section 10. The Consumer Fraud and Deceptive Business
25Practices Act is amended by adding Section 2EEEE as follows:
 

 

 

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1    (815 ILCS 505/2EEEE new)
2    Sec. 2EEEE. Violations concerning teledentistry under the
3Illinois Dental Practice Act. Any person who violates Section
417.2 of the Illinois Dental Practice Act commits an unlawful
5practice within the meaning of this Act.
 
6    Section 99. Effective date. This Act takes effect upon
7becoming law.".