Public Act 103-0902
 
SB2586 EnrolledLRB103 32717 SPS 62470 b

    AN ACT concerning regulation.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Illinois Dental Practice Act is amended by
changing Sections 4, 18.1, and 23 and by adding Section 17.2 as
follows:
 
    (225 ILCS 25/4)
    (Section scheduled to be repealed on January 1, 2026)
    Sec. 4. Definitions. As used in this Act:
    "Address of record" means the designated address recorded
by the Department in the applicant's or licensee's application
file or license file as maintained by the Department's
licensure maintenance unit. It is the duty of the applicant or
licensee to inform the Department of any change of address and
those changes must be made either through the Department's
website or by contacting the Department.
    "Department" means the Department of Financial and
Professional Regulation.
    "Secretary" means the Secretary of Financial and
Professional Regulation.
    "Board" means the Board of Dentistry.
    "Dentist" means a person who has received a general
license pursuant to paragraph (a) of Section 11 of this Act and
who may perform any intraoral and extraoral procedure required
in the practice of dentistry and to whom is reserved the
responsibilities specified in Section 17.
    "Dental hygienist" means a person who holds a license
under this Act to perform dental services as authorized by
Section 18.
    "Dental assistant" means an appropriately trained person
who, under the supervision of a dentist, provides dental
services as authorized by Section 17.
    "Expanded function dental assistant" means a dental
assistant who has completed the training required by Section
17.1 of this Act.
    "Dental laboratory" means a person, firm, or corporation
which:
        (i) engages in making, providing, repairing, or
    altering dental prosthetic appliances and other artificial
    materials and devices which are returned to a dentist for
    insertion into the human oral cavity or which come in
    contact with its adjacent structures and tissues; and
        (ii) utilizes or employs a dental technician to
    provide such services; and
        (iii) performs such functions only for a dentist or
    dentists.
    "Supervision" means supervision of a dental hygienist or a
dental assistant requiring that a dentist authorize the
procedure, remain in the dental facility while the procedure
is performed, and approve the work performed by the dental
hygienist or dental assistant before dismissal of the patient,
but does not mean that the dentist must be present at all times
in the treatment room.
    "General supervision" means supervision of a dental
hygienist requiring that the patient be a patient of record,
that the dentist examine the patient in accordance with
Section 18 prior to treatment by the dental hygienist, and
that the dentist authorize the procedures which are being
carried out by a notation in the patient's record, but not
requiring that a dentist be present when the authorized
procedures are being performed. The issuance of a prescription
to a dental laboratory by a dentist does not constitute
general supervision.
    "Public member" means a person who is not a health
professional. For purposes of board membership, any person
with a significant financial interest in a health service or
profession is not a public member.
    "Dentistry" means the healing art which is concerned with
the examination, diagnosis, treatment planning, and care of
conditions within the human oral cavity and its adjacent
tissues and structures, as further specified in Section 17.
    "Branches of dentistry" means the various specialties of
dentistry which, for purposes of this Act, shall be limited to
the following: endodontics, oral and maxillofacial surgery,
orthodontics and dentofacial orthopedics, pediatric dentistry,
periodontics, prosthodontics, oral and maxillofacial
radiology, and dental anesthesiology.
    "Specialist" means a dentist who has received a specialty
license pursuant to Section 11(b).
    "Dental technician" means a person who owns, operates, or
is employed by a dental laboratory and engages in making,
providing, repairing, or altering dental prosthetic appliances
and other artificial materials and devices which are returned
to a dentist for insertion into the human oral cavity or which
come in contact with its adjacent structures and tissues.
    "Informed consent" means legally valid consent that is
given by a patient or legal guardian, that is recorded in
writing or digitally, that authorizes intervention or
treatment services from the treating dentist, and that
documents agreement to participate in those services and
knowledge of the risks, benefits, and alternatives, including
the decision to withdraw from or decline treatment.
    "Impaired dentist" or "impaired dental hygienist" means a
dentist or dental hygienist who is unable to practice with
reasonable skill and safety because of a physical or mental
disability as evidenced by a written determination or written
consent based on clinical evidence, including deterioration
through the aging process, loss of motor skills, abuse of
drugs or alcohol, or a psychiatric disorder, of sufficient
degree to diminish the person's ability to deliver competent
patient care.
    "Nurse" means a registered professional nurse, a certified
registered nurse anesthetist licensed as an advanced practice
registered nurse, or a licensed practical nurse licensed under
the Nurse Practice Act.
    "Patient of record", except as provided in Section 17.2,
means a patient for whom the patient's most recent dentist has
obtained a relevant medical and dental history and on whom the
dentist has performed a physical an examination within the
last year and evaluated the condition to be treated, including
a review of the patient's most recent x-rays.
    "Dental responder" means a dentist or dental hygienist who
is appropriately certified in disaster preparedness,
immunizations, and dental humanitarian medical response
consistent with the Society of Disaster Medicine and Public
Health and training certified by the National Incident
Management System or the National Disaster Life Support
Foundation.
    "Mobile dental van or portable dental unit" means any
self-contained or portable dental unit in which dentistry is
practiced that can be moved, towed, or transported from one
location to another in order to establish a location where
dental services can be provided.
    "Public health dental hygienist" means a hygienist who
holds a valid license to practice in the State, has 2 years of
full-time clinical experience or an equivalent of 4,000 hours
of clinical experience, and has completed at least 42 clock
hours of additional structured courses in dental education in
advanced areas specific to public health dentistry.
    "Public health setting" means a federally qualified health
center; a federal, State, or local public health facility;
Head Start; a special supplemental nutrition program for
Women, Infants, and Children (WIC) facility; a certified
school-based health center or school-based oral health
program; a prison; or a long-term care facility.
    "Public health supervision" means the supervision of a
public health dental hygienist by a licensed dentist who has a
written public health supervision agreement with that public
health dental hygienist while working in an approved facility
or program that allows the public health dental hygienist to
treat patients, without a dentist first examining the patient
and being present in the facility during treatment, (1) who
are eligible for Medicaid or (2) who are uninsured or whose
household income is not greater than 300% of the federal
poverty level.
    "Teledentistry" means the use of telehealth systems and
methodologies in dentistry and includes patient diagnosis,
treatment planning, care, and education delivery for a patient
of record using synchronous and asynchronous communications
under an Illinois licensed a dentist's authority as provided
under this Act.
(Source: P.A. 102-93, eff. 1-1-22; 102-588, eff. 8-20-21;
102-936, eff. 1-1-23; 103-425, eff. 1-1-24; 103-431, eff.
1-1-24; revised 12-15-23.)
 
    (225 ILCS 25/17.2 new)
    Sec. 17.2. Teledentistry.
    (a) As used in this Section, "patient of record" means a
patient for whom the patient's most recent Illinois-licensed
dentist has obtained a relevant medical and dental history and
on whom the dentist has (i) performed a physical examination
within the last year; (ii) obtained relevant records that are
appropriate for the type of teledentistry service being
provided from an in-person examination within the previous 12
months, including a review of the patient's most recent
x-rays; or (iii) established a relationship with the patient
through an exchange of protected health information for the
purpose of providing emergency care, treatment, or services in
accordance with subsection (c).
    (b) A dentist may only practice or utilize teledentistry
on a patient of record. A dentist practicing dentistry through
teledentistry is subject to the same standard of care and
practice standards that are applicable to dental services
provided in a clinic or office setting. A dentist may provide
and delegate dental services using teledentistry only under
the supervision requirements as specified in this Act for
in-person care. Prior to providing teledentistry services to a
patient, a dentist must obtain informed consent from the
patient as to the treatment proposed to be offered through
teledentistry by the dentist. A dentist providing
teledentistry under this Section shall provide the patient
with the his or her name, direct telephone number, and
physical practice address. It is a violation of this Act for a
provider of dental services rendering care through
teledentistry to require a patient to sign an agreement that
limits in any way the patient's ability to write a review of
services received or file a complaint with the Department or
other regulatory agency. The Department shall adopt rules to
provide for the use of teledentistry in the State of Illinois.
    (c) A dentist may treat a patient of record to provide
emergent care or conduct an initial consultation using
teledentistry for the purpose of treating or assessing for
acute pain, infection, injury, or any intraoral or perioral
condition that presents immediate harm or discomfort to the
patient for which treatment cannot be postponed. A provider of
dental services rendering emergent care or conducting an
initial consultation through teledentistry must direct the
patient to receive appropriate in-person care after the
provision of teledentistry services.
 
    (225 ILCS 25/18.1)
    (Section scheduled to be repealed on January 1, 2026)
    Sec. 18.1. Public health dental supervision
responsibilities.
    (a) When working together in a public health supervision
relationship, dentists and public health dental hygienists
shall enter into a public health supervision agreement. The
dentist providing public health supervision must:
        (1) be available to provide an appropriate level of
    contact, communication, collaboration, and consultation
    with the public health dental hygienist and must meet
    in-person with the public health dental hygienist at least
    quarterly for review and consultation;
        (2) have specific standing orders or policy guidelines
    for procedures that are to be carried out for each
    location or program, although the dentist need not be
    present when the procedures are being performed;
        (3) provide for the patient's additional necessary
    care in consultation with the public health dental
    hygienist;
        (4) file agreements and notifications as required; and
        (5) include procedures for creating and maintaining
    dental records, including protocols for transmission of
    all records between the public health dental hygienist and
    the dentist following each treatment, which shall include
    a notation regarding procedures authorized by the dentist
    and performed by the public health dental hygienist and
    the location where those records are to be kept.
    Each dentist and hygienist who enters into a public health
supervision agreement must document and maintain a copy of any
change or termination of that agreement.
    Dental records shall be owned and maintained by the
supervising dentist for all patients treated under public
health supervision, unless the supervising dentist is an
employee of a public health clinic or federally qualified
health center, in which case the public health clinic or
federally qualified health center shall maintain the records.
    If a dentist ceases to be employed or contracted by the
facility, the dentist shall notify the facility administrator
that the public health supervision agreement is no longer in
effect. A new public health supervision agreement is required
for the public health dental hygienist to continue treating
patients under public health supervision.
    A dentist entering into an agreement under this Section
may supervise and enter into agreements for public health
supervision with 4 public health dental hygienists. This shall
be in addition to the limit of 4 dental hygienists per dentist
set forth in subsection (g) of Section 18 of this Act.
    (b) A public health dental hygienist providing services
under public health supervision may perform only those duties
within the accepted scope of practice of dental hygiene, as
follows:
        (1) the operative procedures of dental hygiene,
    consisting of oral prophylactic procedures, including
    prophylactic cleanings, application of fluoride, and
    placement of sealants;
        (2) the exposure and processing of x-ray films of the
    teeth and surrounding structures; and
        (3) such other procedures and acts as shall be
    prescribed by rule of the Department.
    Any patient treated under this subsection (b) must be
examined by a dentist before additional services can be
provided by a public health dental hygienist. However, if the
supervising dentist, after consultation with the public health
hygienist, determines that time is needed to complete an
approved treatment plan on a patient eligible under this
Section, then the dentist may instruct the hygienist to
complete the remaining services prior to an oral examination
by the dentist. Such instruction by the dentist to the
hygienist shall be noted in the patient's records. Any
services performed under this exception must be scheduled in a
timely manner and shall not occur more than 30 days after the
first appointment date.
    (c) A public health dental hygienist providing services
under public health supervision must:
        (1) provide to the patient, parent, or guardian a
    written plan for referral or an agreement for follow-up
    that records all conditions observed that should be called
    to the attention of a dentist for proper diagnosis;
        (2) have each patient sign a permission slip or
    consent form that informs them that the service to be
    received does not take the place of regular dental
    checkups at a dental office and is meant for people who
    otherwise would not have access to the service;
        (3) inform each patient who may require further dental
    services of that need;
        (4) maintain an appropriate level of contact and
    communication with the dentist providing public health
    supervision; and
        (5) complete an additional 4 hours of continuing
    education in areas specific to public health dentistry
    yearly.
    (d) Each public health dental hygienist who has rendered
services under subsections (c), (d), and (e) of this Section
must complete a summary report at the completion of a program
or, in the case of an ongoing program, at least annually. The
report must be completed in the manner specified by the
Department of Public Health Oral Health Section including
information about each location where the public health dental
hygienist has rendered these services. The public health
dental hygienist must submit the form to the dentist providing
supervision for his or her signature before sending it to the
Division. The Department of Public Health Oral Health Section
shall compile and publicize public health dental hygienist
service data annually.
    (e) Public health dental hygienists providing services
under public health supervision may be compensated for their
work by salary, honoraria, and other mechanisms by the
employing or sponsoring entity. Nothing in this Act shall
preclude the entity that employs or sponsors a public health
dental hygienist from seeking payment, reimbursement, or other
source of funding for the services provided.
    (e-5) A patient who is provided services under a
supervision agreement by a public health dental hygienist as
described in this Section does not need to receive a physical
examination from a dentist prior to treatment if the public
health dental hygienist consults with the supervising dentist
prior to performing the teledentistry service.
    (f) This Section is repealed on January 1, 2026.
(Source: P.A. 103-431, eff. 1-1-24.)
 
    (225 ILCS 25/23)  (from Ch. 111, par. 2323)
    (Section scheduled to be repealed on January 1, 2026)
    Sec. 23. Refusal, revocation or suspension of dental
licenses. The Department may refuse to issue or renew, or may
revoke, suspend, place on probation, reprimand or take other
disciplinary or non-disciplinary action as the Department may
deem proper, including imposing fines not to exceed $10,000
per violation, with regard to any license for any one or any
combination of the following causes:
        1. Fraud or misrepresentation in applying for or
    procuring a license under this Act, or in connection with
    applying for renewal of a license under this Act.
        2. Inability to practice with reasonable judgment,
    skill, or safety as a result of habitual or excessive use
    or addiction to alcohol, narcotics, stimulants, or any
    other chemical agent or drug.
        3. Willful or repeated violations of the rules of the
    Department of Public Health or Department of Nuclear
    Safety.
        4. Acceptance of a fee for service as a witness,
    without the knowledge of the court, in addition to the fee
    allowed by the court.
        5. Division of fees or agreeing to split or divide the
    fees received for dental services with any person for
    bringing or referring a patient, except in regard to
    referral services as provided for under Section 45, or
    assisting in the care or treatment of a patient, without
    the knowledge of the patient or his or her legal
    representative. Nothing in this item 5 affects any bona
    fide independent contractor or employment arrangements
    among health care professionals, health facilities, health
    care providers, or other entities, except as otherwise
    prohibited by law. Any employment arrangements may include
    provisions for compensation, health insurance, pension, or
    other employment benefits for the provision of services
    within the scope of the licensee's practice under this
    Act. Nothing in this item 5 shall be construed to require
    an employment arrangement to receive professional fees for
    services rendered.
        6. Employing, procuring, inducing, aiding or abetting
    a person not licensed or registered as a dentist or dental
    hygienist to engage in the practice of dentistry or dental
    hygiene. The person practiced upon is not an accomplice,
    employer, procurer, inducer, aider, or abetter within the
    meaning of this Act.
        7. Making any misrepresentations or false promises,
    directly or indirectly, to influence, persuade or induce
    dental patronage.
        8. Professional connection or association with or
    lending his or her name to another for the illegal
    practice of dentistry by another, or professional
    connection or association with any person, firm or
    corporation holding himself, herself, themselves, or
    itself out in any manner contrary to this Act.
        9. Obtaining or seeking to obtain practice, money, or
    any other things of value by false or fraudulent
    representations, but not limited to, engaging in such
    fraudulent practice to defraud the medical assistance
    program of the Department of Healthcare and Family
    Services (formerly Department of Public Aid) under the
    Illinois Public Aid Code.
        10. Practicing under a false or, except as provided by
    law, an assumed name.
        11. Engaging in dishonorable, unethical, or
    unprofessional conduct of a character likely to deceive,
    defraud, or harm the public.
        12. Conviction by plea of guilty or nolo contendere,
    finding of guilt, jury verdict, or entry of judgment or by
    sentencing for any crime, including, but not limited to,
    convictions, preceding sentences of supervision,
    conditional discharge, or first offender probation, under
    the laws of any jurisdiction of the United States that (i)
    is a felony under the laws of this State or (ii) is a
    misdemeanor, an essential element of which is dishonesty,
    or that is directly related to the practice of dentistry.
        13. Permitting a dental hygienist, dental assistant or
    other person under his or her supervision to perform any
    operation not authorized by this Act.
        14. Permitting more than 4 dental hygienists to be
    employed under his or her supervision at any one time.
        15. A violation of any provision of this Act or any
    rules promulgated under this Act.
        16. Taking impressions for or using the services of
    any person, firm or corporation violating this Act.
        17. Violating any provision of Section 45 relating to
    advertising.
        18. Discipline by another U.S. jurisdiction or foreign
    nation, if at least one of the grounds for the discipline
    is the same or substantially equivalent to those set forth
    within this Act.
        19. Willfully failing to report an instance of
    suspected child abuse or neglect as required by the Abused
    and Neglected Child Reporting Act.
        20. Gross negligence in practice under this Act.
        21. The use or prescription for use of narcotics or
    controlled substances or designated products as listed in
    the Illinois Controlled Substances Act, in any way other
    than for therapeutic purposes.
        22. Willfully making or filing false records or
    reports in his or her practice as a dentist, including,
    but not limited to, false records to support claims
    against the dental assistance program of the Department of
    Healthcare and Family Services (formerly Illinois
    Department of Public Aid).
        23. Professional incompetence as manifested by poor
    standards of care.
        24. Physical or mental illness, including, but not
    limited to, deterioration through the aging process, or
    loss of motor skills which results in a dentist's
    inability to practice dentistry with reasonable judgment,
    skill or safety. In enforcing this paragraph, the
    Department may compel a person licensed to practice under
    this Act to submit to a mental or physical examination
    pursuant to the terms and conditions of Section 23b.
        25. Gross or repeated irregularities in billing for
    services rendered to a patient. For purposes of this
    paragraph 25, "irregularities in billing" shall include:
            (a) Reporting excessive charges for the purpose of
        obtaining a total payment in excess of that usually
        received by the dentist for the services rendered.
            (b) Reporting charges for services not rendered.
            (c) Incorrectly reporting services rendered for
        the purpose of obtaining payment not earned.
        26. Continuing the active practice of dentistry while
    knowingly having any infectious, communicable, or
    contagious disease proscribed by rule or regulation of the
    Department.
        27. Being named as a perpetrator in an indicated
    report by the Department of Children and Family Services
    pursuant to the Abused and Neglected Child Reporting Act,
    and upon proof by clear and convincing evidence that the
    licensee has caused a child to be an abused child or
    neglected child as defined in the Abused and Neglected
    Child Reporting Act.
        28. Violating the Health Care Worker Self-Referral
    Act.
        29. Abandonment of a patient.
        30. Mental incompetency as declared by a court of
    competent jurisdiction.
        31. A finding by the Department that the licensee,
    after having his or her license placed on probationary
    status, has violated the terms of probation.
        32. Material misstatement in furnishing information to
    the Department.
        33. Failing, within 60 days, to provide information in
    response to a written request by the Department in the
    course of an investigation.
        34. Immoral conduct in the commission of any act,
    including, but not limited to, commission of an act of
    sexual misconduct related to the licensee's practice.
        35. Cheating on or attempting to subvert the licensing
    examination administered under this Act.
        36. A pattern of practice or other behavior that
    demonstrates incapacity or incompetence to practice under
    this Act.
        37. Failure to establish and maintain records of
    patient care and treatment as required under this Act.
        38. Failure to provide copies of dental records as
    required by law.
        39. Failure of a licensed dentist who owns or is
    employed at a dental office to give notice of an office
    closure to his or her patients at least 30 days prior to
    the office closure pursuant to Section 50.1.
        40. Failure to maintain a sanitary work environment.
        41. Failure to comply with the provisions of Section
    17.2 of this Act.
    All proceedings to suspend, revoke, place on probationary
status, or take any other disciplinary action as the
Department may deem proper, with regard to a license on any of
the foregoing grounds, must be commenced within 5 years after
receipt by the Department of a complaint alleging the
commission of or notice of the conviction order for any of the
acts described herein. Except for fraud in procuring a
license, no action shall be commenced more than 7 years after
the date of the incident or act alleged to have violated this
Section. The time during which the holder of the license was
outside the State of Illinois shall not be included within any
period of time limiting the commencement of disciplinary
action by the Department.
    All fines imposed under this Section shall be paid within
60 days after the effective date of the order imposing the fine
or in accordance with the terms set forth in the order imposing
the fine.
    The Department may refuse to issue or may suspend the
license of any person who fails to file a return, or to pay the
tax, penalty or interest shown in a filed return, or to pay any
final assessment of tax, penalty or interest, as required by
any tax Act administered by the Illinois Department of
Revenue, until such time as the requirements of any such tax
Act are satisfied.
    Any dentist who has had his or her license suspended or
revoked for more than 5 years must comply with the
requirements for restoration set forth in Section 16 prior to
being eligible for reinstatement from the suspension or
revocation.
(Source: P.A. 103-425, eff. 1-1-24.)
 
    Section 10. The Consumer Fraud and Deceptive Business
Practices Act is amended by adding Section 2EEEE as follows:
 
    (815 ILCS 505/2EEEE new)
    Sec. 2EEEE. Violations concerning teledentistry under the
Illinois Dental Practice Act. Any person who violates Section
17.2 of the Illinois Dental Practice Act commits an unlawful
practice within the meaning of this Act.
 
    Section 99. Effective date. This Act takes effect upon
becoming law.

Effective Date: 8/9/2024