HB4501ham001 102ND GENERAL ASSEMBLY

Rep. Katie Stuart

Filed: 2/28/2022

 

 


 

 


 
10200HB4501ham001LRB102 22484 AMQ 36885 a

1
AMENDMENT TO HOUSE BILL 4501

2    AMENDMENT NO. ______. Amend House Bill 4501 on page 1,
3line 5, by replacing "and 17.1" with "17.1, and 18"; and
 
4on page 6, line 11, by deleting the word "limited"; and
 
5on page 6, line 12, by replacing "care" with "care"; and
 
6on page 11, line 20, by deleting the word "limited"; and
 
7on page 11, line 21, by replacing "care" with "care"; and
 
8on page 14, line 5, by replacing "delegate dental" with
9"delegate limited dental"; and
 
10on page 14, line 8, by replacing "care." with "care; or"; and
 
11on page 14, immediately after line 8, by inserting the

 

 

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1following:
2        "(13) A dentist practicing dentistry through
3    teledentistry is subject to the same standard of care as
4    if those services were being delivered in a clinic or
5    office setting."; and
 
6on page 23, by replacing lines 17 through 19 with the
7following:
8        "(3) Placing, carving, and finishing of amalgam
9    restorations and placing, packing, and finishing composite
10    restorations as allowed under Section 17."; and
 
11on page 25, immediately below line 13, by inserting the
12following:
 
13    "(225 ILCS 25/18)   (from Ch. 111, par. 2318)
14    (Section scheduled to be repealed on January 1, 2026)
15    Sec. 18. Acts constituting the practice of dental hygiene;
16limitations.
17    (a) A person practices dental hygiene within the meaning
18of this Act when he or she performs the following acts under
19the supervision of a dentist:
20        (i) the operative procedure of dental hygiene,
21    consisting of oral prophylactic procedures;
22        (ii) the exposure and processing of X-Ray films of the
23    teeth and surrounding structures;

 

 

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1        (iii) the application to the surfaces of the teeth or
2    gums of chemical compounds designed to be desensitizing
3    agents or effective agents in the prevention of dental
4    caries or periodontal disease;
5        (iv) all services which may be performed by a dental
6    assistant as specified by rule pursuant to Section 17, and
7    a dental hygienist may engage in the placing, carving, and
8    finishing of amalgam restorations only after obtaining
9    formal education and certification as determined by the
10    Department;
11        (v) administration and monitoring of nitrous oxide
12    upon successful completion of a training program approved
13    by the Department;
14        (vi) administration of local anesthetics upon
15    successful completion of a training program approved by
16    the Department; and
17        (vii) such other procedures and acts as shall be
18    prescribed by rule or regulation of the Department.
19    (b) A dental hygienist may be employed or engaged only:
20        (1) by a dentist;
21        (2) by a federal, State, county, or municipal agency
22    or institution;
23        (3) by a public or private school; or
24        (4) by a public clinic operating under the direction
25    of a hospital or federal, State, county, municipal, or
26    other public agency or institution.

 

 

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1    (c) When employed or engaged in the office of a dentist, a
2dental hygienist may perform, under general supervision, those
3procedures found in items (i) through (iv) of subsection (a)
4of this Section, provided the patient has been examined by the
5dentist within one year of the provision of dental hygiene
6services, the dentist has approved the dental hygiene services
7by a notation in the patient's record and the patient has been
8notified that the dentist may be out of the office during the
9provision of dental hygiene services.
10    (d) If a patient of record is unable to travel to a dental
11office because of illness, infirmity, or imprisonment, a
12dental hygienist may perform, under the general supervision of
13a dentist, those procedures found in items (i) through (iv) of
14subsection (a) of this Section, provided the patient is
15located in a long-term care facility licensed by the State of
16Illinois, a mental health or developmental disability
17facility, or a State or federal prison. The dentist shall
18either personally examine and diagnose the patient or utilize
19approved teledentistry communication methods and determine
20which services are necessary to be performed, which shall be
21contained in an order to the hygienist and a notation in the
22patient's record. Such order must be implemented within 120
23days of its issuance, and an updated medical history and
24observation of oral conditions must be performed by the
25hygienist immediately prior to beginning the procedures to
26ensure that the patient's health has not changed in any manner

 

 

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1to warrant a reexamination by the dentist.
2    (e) School-based oral health care, consisting of and
3limited to oral prophylactic procedures, sealants, and
4fluoride treatments, may be provided by a dental hygienist
5under the general supervision of a dentist. A dental hygienist
6may not provide other dental hygiene treatment in a
7school-based setting, including but not limited to
8administration or monitoring of nitrous oxide or
9administration of local anesthetics. The school-based
10procedures may be performed provided the patient is located at
11a public or private school and the program is being conducted
12by a State, county or local public health department
13initiative or in conjunction with a dental school or dental
14hygiene program. The dentist shall personally examine and
15diagnose the patient and determine which services are
16necessary to be performed, which shall be contained in an
17order to the hygienist and a notation in the patient's record.
18Any such order for sealants must be implemented within 120
19days after its issuance. Any such order for oral prophylactic
20procedures or fluoride treatments must be implemented within
21180 days after its issuance. An updated medical history and
22observation of oral conditions must be performed by the
23hygienist immediately prior to beginning the procedures to
24ensure that the patient's health has not changed in any manner
25to warrant a reexamination by the dentist.
26    (f) Without the supervision of a dentist, a dental

 

 

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1hygienist may perform dental health education functions,
2including instruction in proper oral health care and dental
3hygiene in either a school setting or long-term care facility.
4In addition, a dental hygienist and may record care case
5histories and oral conditions observed at any time prior to a
6clinical exam by a dentist.
7    (g) The number of dental hygienists practicing in a dental
8office shall not exceed, at any one time, 4 times the number of
9dentists practicing in the office at the time.
10    (h) A dental hygienist who is certified as a public health
11dental hygienist may provide services to patients: (1) who are
12eligible for Medicaid or (2) who are uninsured and whose
13household income is not greater than 200% of the federal
14poverty level. A public health dental hygienist may perform
15oral assessments, perform screenings, and provide educational
16and preventative services as provided in subsection (b) of
17Section 18.1 of this Act. The public health dental hygienist
18may not administer local anesthesia or nitrous oxide, or
19place, carve, or finish amalgam restorations or provide
20periodontal therapy under this exception. Each patient must
21sign a consent form that acknowledges that the care received
22does not take the place of a regular dental examination. The
23public health dental hygienist must provide the patient or
24guardian a written referral to a dentist for assessment of the
25need for further dental care at the time of treatment. Any
26indication or observation of a condition that could warrant

 

 

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1the need for urgent attention must be reported immediately to
2the supervising dentist for appropriate assessment and
3treatment.
4    This subsection (h) is inoperative on and after January 1,
52026.
6    (i) A dental hygienist performing procedures listed in
7paragraphs (1) through (4) of subsection (a) of Section 17.1
8must be under the supervision of a dentist, requiring the
9dentist authorizes the procedure, remains in the dental
10facility while the procedure is performed, and approves the
11work performed by the dental hygienist before dismissal of the
12patient, but the dentist is not required to be present at all
13times in the treatment room.
14    (j) A dental hygienist may perform actions described in
15paragraph (5) of subsection (a) of Section 17.1 under the
16general supervision of a dentist as described in this Section.
17(Source: P.A. 100-976, eff. 1-1-19; 101-162, eff. 7-26-19.)".