Full Text of SB1919 097th General Assembly
SB1919 97TH GENERAL ASSEMBLY |
| | 97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012 SB1919 Introduced 2/10/2011, by Sen. Donne E. Trotter SYNOPSIS AS INTRODUCED: |
| 225 ILCS 25/4 | from Ch. 111, par. 2304 | 225 ILCS 25/18 | from Ch. 111, par. 2318 |
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Amends the Illinois Dental Practice Act. Provides that a dental hygienist may be employed or engaged by a licensed physician. Provides that a dental hygienist may be employed or retained by a health care facility, program, or nonprofit organization to perform dental hygiene services without the patient first being examined by a licensed dentist if the dental hygienist (i) has engaged in active practice of clinical dental hygiene for a minimum of 2,400 hours in the past 18 months or a career total of 3,000 hours, (ii) has entered into a collaborative agreement with a licensed dentist, (iii) had documented participation in course in infection control and medical emergencies, and (iv) maintains current CPR certification. Authorizes the dental hygienist to perform limited specified services. Provides that a licensed dentist may not have a collaborative agreement with more than 4 dental hygienist unless otherwise authorized by the Board. Provides that the collaborative agreement must (i) include certain provisions and it must be signed and maintained by the dentist, the dental hygienist, and the facility, program, or organization, (ii) be reviewed yearly, and (iii) be made available to the Board upon request. Effective immediately.
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| | A BILL FOR |
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| 1 | | AN ACT concerning regulation.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Illinois Dental Practice Act is amended by | 5 | | changing Sections 4 and 18 as follows:
| 6 | | (225 ILCS 25/4)
(from Ch. 111, par. 2304)
| 7 | | (Section scheduled to be repealed on January 1, 2016)
| 8 | | Sec. 4. Definitions. As used in this Act:
| 9 | | (a) "Department" means the Illinois Department of | 10 | | Professional Regulation.
| 11 | | (b) "Director" means the Director of Professional | 12 | | Regulation.
| 13 | | (c) "Board" means the Board of Dentistry established by | 14 | | Section 6 of this
Act.
| 15 | | (d) "Dentist" means a person who has received a general | 16 | | license pursuant
to paragraph (a) of Section 11 of this Act and | 17 | | who may perform any intraoral
and extraoral procedure required | 18 | | in the practice of dentistry and to whom is
reserved the | 19 | | responsibilities specified in Section 17.
| 20 | | (e) "Dental hygienist" means a person who holds a license | 21 | | under this Act to
perform dental services as authorized by | 22 | | Section 18.
| 23 | | (f) "Dental assistant" means an appropriately trained |
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| 1 | | person
who, under the supervision of a dentist, provides dental | 2 | | services
as authorized by Section 17.
| 3 | | (g) "Dental laboratory" means a person, firm or corporation | 4 | | which:
| 5 | | (i) engages in making, providing, repairing or | 6 | | altering dental
prosthetic appliances and other artificial | 7 | | materials and devices which are
returned to a dentist for | 8 | | insertion into the human oral cavity or which
come in | 9 | | contact with its adjacent structures and tissues; and
| 10 | | (ii) utilizes or employs a dental technician to provide | 11 | | such services; and
| 12 | | (iii) performs such functions only for a dentist or | 13 | | dentists.
| 14 | | (h) "Supervision" means supervision of a dental hygienist | 15 | | or a dental
assistant requiring that a dentist authorize the | 16 | | procedure, remain in the
dental facility while the procedure is | 17 | | performed, and approve the work
performed by the dental | 18 | | hygienist or dental assistant before dismissal of
the patient, | 19 | | but does not mean that the dentist must be present at all
times | 20 | | in the treatment room.
| 21 | | (i) "General supervision" means supervision of a dental | 22 | | hygienist
requiring that the patient be a patient of record,
| 23 | | that the dentist
examine the patient in accordance with Section | 24 | | 18 prior to treatment by the
dental hygienist, and that the
| 25 | | dentist authorize the procedures which
are being carried
out by | 26 | | a notation in the patient's record, but not requiring that a |
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| 1 | | dentist
be present when the authorized
procedures are being | 2 | | performed. The
issuance of a prescription to a dental | 3 | | laboratory by a
dentist does not constitute general | 4 | | supervision.
| 5 | | (j) "Collaborative agreement" means a written agreement | 6 | | between a licensed dental hygienist and a collaborating | 7 | | licensed dentist. | 8 | | (k) (j) "Public member" means a person who is not a health | 9 | | professional.
For purposes of board membership, any person with | 10 | | a significant financial
interest in a health service or | 11 | | profession is not a public member.
| 12 | | (l) (k) "Dentistry" means the healing art which is | 13 | | concerned with the
examination, diagnosis, treatment planning | 14 | | and care of conditions within
the human oral cavity and its | 15 | | adjacent tissues and structures, as further
specified in | 16 | | Section 17.
| 17 | | (m) (l) "Branches of dentistry" means the various | 18 | | specialties of dentistry
which, for purposes of this Act, shall | 19 | | be limited to the following:
endodontics, oral and | 20 | | maxillofacial surgery, orthodontics and dentofacial
| 21 | | orthopedics, pediatric dentistry,
periodontics, | 22 | | prosthodontics, and oral and maxillofacial
radiology.
| 23 | | (n) (m) "Specialist" means a dentist who has received a | 24 | | specialty license
pursuant to Section 11(b).
| 25 | | (o) (n) "Dental technician" means a person who owns, | 26 | | operates or is
employed by a dental laboratory and engages in |
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| 1 | | making, providing, repairing
or altering dental prosthetic | 2 | | appliances and other artificial materials and
devices which are | 3 | | returned to a dentist for insertion into the human oral
cavity | 4 | | or which come in contact with its adjacent structures and | 5 | | tissues.
| 6 | | (p) (o) "Impaired dentist" or "impaired dental hygienist" | 7 | | means a dentist
or dental hygienist who is unable to practice | 8 | | with
reasonable skill and safety because of a physical or | 9 | | mental disability as
evidenced by a written determination or | 10 | | written consent based on clinical
evidence, including | 11 | | deterioration through the aging process, loss of motor
skills, | 12 | | abuse of drugs or alcohol, or a psychiatric disorder, of | 13 | | sufficient
degree to diminish the person's ability to deliver | 14 | | competent patient care.
| 15 | | (q) (p) "Nurse" means a registered professional nurse, a | 16 | | certified registered
nurse anesthetist licensed as an advanced | 17 | | practice
nurse, or a licensed practical nurse licensed under | 18 | | the Nurse Practice Act.
| 19 | | (r) (q) "Patient of record" means a patient for whom the | 20 | | patient's most recent
dentist has obtained
a
relevant medical | 21 | | and dental history and on whom the dentist has performed an
| 22 | | examination and evaluated the condition to be treated.
| 23 | | (s) (r) "Dental emergency responder" means a dentist or | 24 | | dental hygienist who is appropriately certified in emergency | 25 | | medical response, as defined by the Department of Public | 26 | | Health.
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| 1 | | (t) "Public health setting" means a hospital; nursing home; | 2 | | home health agency; group home serving the elderly, disabled or | 3 | | juveniles; State-operated facility licensed by the | 4 | | Commissioner of Human Services or the Commissioner of | 5 | | Corrections; federal, State, or local public health facility; | 6 | | community clinic; school authority; Head start program; | 7 | | Maternal and Child Health WIC program; or a program operated by | 8 | | a non-profit organization that services individuals who are | 9 | | uninsured or who are Illinois health care public program | 10 | | recipients. | 11 | | (Source: P.A. 94-409, eff. 12-31-05; 95-639, eff. 10-5-07.)
| 12 | | (225 ILCS 25/18)
(from Ch. 111, par. 2318)
| 13 | | (Section scheduled to be repealed on January 1, 2016)
| 14 | | Sec. 18. Acts constituting the practice of dental hygiene;
| 15 | | limitations. | 16 | | (a) A person practices dental hygiene within the meaning of | 17 | | this Act when
he or she performs the following acts under the | 18 | | supervision of a dentist:
| 19 | | (i) the operative procedure of dental hygiene, | 20 | | consisting of oral
prophylactic procedures;
| 21 | | (ii) the exposure and processing of X-Ray films of | 22 | | the teeth and
surrounding structures;
| 23 | | (iii) the application to the surfaces of the teeth | 24 | | or gums of chemical
compounds designed to be | 25 | | desensitizing agents or effective agents in the
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| 1 | | prevention of dental caries or periodontal disease;
| 2 | | (iv) all services which may be performed by a
| 3 | | dental assistant as specified by rule pursuant to | 4 | | Section 17;
| 5 | | (v) administration and monitoring of nitrous oxide | 6 | | upon successful
completion of a
training program | 7 | | approved by the Department;
| 8 | | (vi) administration of local anesthetics upon | 9 | | successful completion of
a
training program approved | 10 | | by the Department; and
| 11 | | (vii) such other procedures and acts as shall be | 12 | | prescribed
by
rule or regulation of the Department.
| 13 | | (b) A dental hygienist may be employed or engaged only:
| 14 | | (1) by a dentist;
| 15 | | (2) by a federal, State, county, or municipal agency or | 16 | | institution;
| 17 | | (3) by a public or private school; or
| 18 | | (4) by a public clinic operating under the direction of | 19 | | a hospital or
federal,
State, county, municipal, or other | 20 | | public agency or institution ; or .
| 21 | | (5) by a physician. | 22 | | (c) When employed or engaged in the office of a dentist, a | 23 | | dental hygienist
may
perform, under general supervision, those | 24 | | procedures found in items (i) through
(iv) of
subsection (a) of | 25 | | this Section, provided the patient has been examined by the
| 26 | | dentist
within one year of the provision of dental hygiene |
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| 1 | | services, the dentist has
approved the
dental hygiene services | 2 | | by a notation in the patient's record and the patient
has been
| 3 | | notified that the dentist may be out of the office during the | 4 | | provision of
dental hygiene
services.
| 5 | | (d) If a patient of record is unable to travel to a dental | 6 | | office because of
illness,
infirmity, or
imprisonment, a dental | 7 | | hygienist may perform, under the general supervision of
a | 8 | | dentist,
those procedures found in items (i) through (iv) of | 9 | | subsection (a) of this
Section,
provided the patient is located | 10 | | in a long-term care facility licensed by the
State of Illinois,
| 11 | | a mental health or developmental disability facility, or a | 12 | | State or federal
prison. The dentist
shall personally examine | 13 | | and diagnose the patient and determine which
services are | 14 | | necessary to be performed, which shall be contained in an order | 15 | | to the hygienist and a notation in the patient's record.
Such | 16 | | order must be implemented within 120 days
of its issuance, and | 17 | | an updated medical history and observation of oral
conditions
| 18 | | must be performed by the hygienist immediately prior to | 19 | | beginning the
procedures to ensure that the patient's health | 20 | | has not changed in any
manner to warrant a reexamination by the | 21 | | dentist.
| 22 | | (e) School-based oral health care,
consisting of and | 23 | | limited to oral prophylactic
procedures, sealants, and | 24 | | fluoride treatments,
may be provided by a dental hygienist
| 25 | | under the general supervision of a dentist. A dental hygienist | 26 | | may not provide
other dental hygiene treatment in a |
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| 1 | | school-based setting, including but not
limited to | 2 | | administration or monitoring of nitrous oxide or | 3 | | administration of
local anesthetics. The school-based | 4 | | procedures may be performed provided the
patient is located at | 5 | | a public or private school and the program is being
conducted | 6 | | by a State, county or local public health department initiative | 7 | | or in
conjunction with a dental school or dental hygiene | 8 | | program.
The dentist shall personally examine and diagnose the | 9 | | patient and
determine
which services are necessary to be | 10 | | performed, which shall be contained in an
order to the
| 11 | | hygienist and a notation in the patient's record. Any such | 12 | | order for sealants must be implemented within 120 days after | 13 | | its issuance. Any such order for oral prophylactic procedures | 14 | | or fluoride treatments must be implemented within 180 days | 15 | | after its issuance. An updated medical history and observation | 16 | | of
oral conditions
must be
performed by the hygienist | 17 | | immediately prior to beginning the procedures to
ensure that
| 18 | | the patient's health has not changed in any manner to warrant a | 19 | | reexamination
by the
dentist.
| 20 | | (f) Without the supervision of a dentist, a dental | 21 | | hygienist
may perform
dental health education functions and may | 22 | | record case histories and oral
conditions observed.
| 23 | | (g) The number of dental hygienists practicing in a dental | 24 | | office shall
not
exceed, at any one time, 4 times the number of | 25 | | dentists practicing in the
office at the time.
| 26 | | (h) Notwithstanding subsections (c), (d), (e), or (f) of |
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| 1 | | Section 18, a dental hygienist
licensed under this Act may be | 2 | | employed or retained by a health care facility,
program, or | 3 | | nonprofit organization to perform dental hygiene services | 4 | | described under
subsection (i) of this Section without the | 5 | | patient first being examined by a licensed dentist if the | 6 | | dental
hygienist: | 7 | | (1) has been engaged in the active practice of clinical | 8 | | dental hygiene for not
less than 2,400 hours in the past 18 | 9 | | months or a career total of 3,000 hours,
including a | 10 | | minimum of 200 hours of clinical practice in 2 of the past | 11 | | 3
years; | 12 | | (2) has entered into a collaborative agreement with a | 13 | | licensed dentist that
designates authorization for the | 14 | | services provided by the dental hygienist; | 15 | | (3) has documented participation in courses in | 16 | | infection control and medical
emergencies within each | 17 | | continuing education cycle; and | 18 | | (4) maintains current CPR certification from | 19 | | completion of the American
Heart Association healthcare | 20 | | provider course, the American Red Cross professional
| 21 | | rescuer course, or an equivalent entity. | 22 | | (i) The dental hygiene services authorized to be performed | 23 | | by a dental hygienist
under this subsection are limited to: | 24 | | (1) screen and assess oral health conditions; | 25 | | (2) preliminary charting of the oral cavity and | 26 | | surrounding structures to
include case histories, perform |
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| 1 | | initial and periodic examinations and assessments to
| 2 | | determine periodontal status, and formulate a dental | 3 | | hygiene treatment plan in
coordination with a dentist's | 4 | | treatment plan; | 5 | | (3) removal of deposits and stains from the surfaces of | 6 | | the teeth; | 7 | | (4) prescribe, administer, and dispense fluoride, | 8 | | fluoride varnish, antimicrobial solutions, or resorbable | 9 | | antimicrobial agents; | 10 | | (5)
apply sealants; | 11 | | (6) polishing and smoothing restorations; | 12 | | (7) removal of marginal overhangs; | 13 | | (8) performance of preliminary charting; | 14 | | (9) taking of radiographs; and | 15 | | (10) performance of scaling and root planing. | 16 | | (j) A collaborating dentist must be licensed under this Act | 17 | | and may enter into
a collaborative agreement with no more than | 18 | | 4 dental hygienists unless
otherwise authorized by the Board. | 19 | | The Board shall develop parameters and a
process for obtaining | 20 | | authorization to collaborate with more than 4 dental
| 21 | | hygienists. The collaborative agreement must include: | 22 | | (1) consideration for medically compromised patients | 23 | | and medical conditions
for which a dental evaluation and | 24 | | treatment plan must occur prior to the provision
of dental | 25 | | hygiene services; | 26 | | (2) age-and procedure-specific standard collaborative |
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| 1 | | practice protocols,
including recommended intervals for | 2 | | the performance of dental hygiene services
and a period of | 3 | | time that an examination by a dentist should occur; | 4 | | (3) copies of consent to treatment form provided to the | 5 | | patient by the dental
hygienist; | 6 | | (4) specific protocols for the placement of pit and | 7 | | fissure sealants and
requirements for follow-up care to | 8 | | assure the efficacy of the sealants after
application; and | 9 | | (5) a procedure for creating and maintaining dental | 10 | | records for the patients that
are treated by the dental | 11 | | hygienist; this procedure must specify where these
records | 12 | | are to be located. | 13 | | (k) The collaborative agreement must be (i) signed and | 14 | | maintained by the dentist, the
dental hygienist, and the | 15 | | facility, program, or organization, (ii) reviewed
annually by | 16 | | the collaborating dentist and dental hygienist, and (iii) made
| 17 | | available to the Board upon request. | 18 | | (l) Before performing any services authorized under this | 19 | | subsection, a dental
hygienist must provide the patient with a | 20 | | consent to treatment form that must
include a statement | 21 | | advising the patient that the dental hygiene services provided
| 22 | | are not a substitute for a dental examination by a licensed | 23 | | dentist. If the dental
hygienist makes any referrals to the | 24 | | patient for further dental procedures, the dental
hygienist | 25 | | must fill out a referral form and provide a copy of the form to | 26 | | the
collaborating dentist. |
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| 1 | | (m) The dental hygienist working under a collaborative | 2 | | agreement and the collaborating dentist must agree to maintain | 3 | | communication and consultation with each other. | 4 | | (n) The dental hygienist working under a collaborative | 5 | | agreement must provide the collaborating dentist opportunities | 6 | | to review patient records as requested. | 7 | | (Source: P.A. 93-113, eff. 1-1-04; 93-821, eff. 7-28-04 .)
| 8 | | Section 99. Effective date. This Act takes effect upon | 9 | | becoming law.
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