Bill Text: HI HB696 | 2018 | Regular Session | Amended
Bill Title: Relating To Health.
Spectrum: Partisan Bill (Democrat 21-1)
Status: (Engrossed - Dead) 2018-03-15 - Received notice of discharge of conferees (Hse. Com. No. 385). [HB696 Detail]
Download: Hawaii-2018-HB696-Amended.html
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
696 |
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TWENTY-NINTH LEGISLATURE, 2017 |
S.D. 1 |
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STATE OF HAWAII |
Proposed |
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A BILL FOR AN ACT
RELATING TO HEALTH.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
PART I
SECTION 1. The legislature finds that the name "board of dental examiners" is no longer an accurate description of the board's scope and function. The legislature finds that the name "board of dentistry and dental hygiene" is a more appropriate and logical choice, since the board's purview encompasses the regulation of dentistry, under chapter 448, Hawaii Revised Statutes, and dental hygienists, under chapter 447, Hawaii Revised Statutes. Furthermore, the board no longer exists merely for purposes related to conducting licensing exams. The board now has additional responsibilities to regulate its members and the profession.
The legislature further finds that there are currently twelve members on the board. Eight of these members are practicing dentists, while only two members are dental hygienists. As of April 13, 2015, there were 1,512 dentists and 1,052 dental hygienists licensed by the State. According to these numbers, one dentist board member represents one hundred eighty-nine licensed dentists, while one dental hygienist board member represents five hundred twenty-six licensed dental hygienists.
Like the eight dentist members on the board, the two dental hygienist members are practicing professionals and must arrange for time off, often as unpaid leave, to fulfill their increasing duties. It is challenging for the two dental hygienist members to carry out their growing responsibilities, which includes providing dental hygienist expertise and perspective, as compared to the eight dentists sharing board member tasks.
The legislature finds that dental hygiene is one of the few health professions that is generally controlled by another profession. Due to the significantly higher representation of dentists on the board, the dental hygienists' contributions and guidance are often not reflected in the board's actions. A 1993 state auditor's report noted that adequate representation for dental hygienists was particularly important, "since the interests of [dental hygienists] may conflict with and be outweighed by those of dentists."
Accordingly, the purpose of this part is to:
(1) Update the name of the board of dental examiners to the board of dentistry and dental hygiene, which more accurately reflects the board's scope; and
(2) Beginning on July 1, 2018, increase the board membership to fifteen members and apportion the dental hygienist representation among Oahu and neighbor island residents.
SECTION 2. Section 448-5, Hawaii Revised Statutes, is amended to read as follows:
"§448-5 Board of [examiners;] dentistry
and dental hygiene; appointment. The board of [dental examiners]
dentistry and dental hygiene shall consist of twelve members, eight of
whom shall be practicing dentists who have been engaged in the practice of
dentistry for a period of five years preceding their several appointments, two
of whom shall be practicing dental hygienists, duly licensed under section
447-1, who have been engaged in the practice of dental hygiene in the State for
a period of five years preceding appointment, and two of whom shall be public members.
No member shall be in any way connected with, or interested financially in, any
dental supply company. One member in the practice of dentistry shall be
appointed from each of the counties of Hawaii, Maui, and Kauai and five members
in the practice of dentistry shall be appointed from the city and county of
Honolulu. As used in this chapter, "board" means the board of [dental
examiners.] dentistry and dental hygiene."
SECTION 3. Section 448-5, Hawaii Revised Statutes, is amended to read as follows:
"§448-5 Board of [examiners;] dentistry
and dental hygiene; appointment. The board of [dental examiners]
dentistry and dental hygiene shall consist of [twelve] fifteen
members, eight of whom shall be practicing dentists who have been engaged in
the practice of dentistry for a period of five years preceding their several
appointments, [two] five of whom shall be practicing dental
hygienists, duly licensed under section 447-1, and who have been engaged
in the practice of dental hygiene in the State for a period of five years
preceding appointment, and two of whom shall be public members. A
background in public health dentistry is a desirable qualification, but not a
requirement, for at least one member of the board who is a practicing dentist.
Of the members who are practicing dental hygienists, three shall be residents
of Oahu, and two shall be residents of neighbor islands. No member shall
be in any way connected with, or interested financially in, any dental supply
company. One member in the practice of dentistry shall be appointed from each
of the counties of Hawaii, Maui, and Kauai and five members in the practice of
dentistry shall be appointed from the city and county of Honolulu. As used in
this chapter, "board" means the board of [dental examiners.] dentistry
and dental hygiene."
SECTION 4. Sections 26-9, 423-1, 447-1(a), 447-1.5, 447-2, 447-3, 447-3.5, 447-4, 447-6, 447-7, 448-1.5, 448-2, 448-3, 448‑7, 448-9.6, 448-11, 448-12, 448-13, 448-16, 448-16.5, 448‑22, 448-23, and 451D-2, Hawaii Revised Statutes, are amended by substituting the words "board of dentistry and dental hygiene", or similar term, wherever the words "board of dental examiners", or similar term, appears, as the context requires.
PART II
SECTION 5. The legislature finds that the current law requiring passage of the American Board of Dental Examiners (ADEX) examination for licensure as a dentist in the State was originally enacted to allow Hawaii to participate in a standardized national examination process. The first ADEX dental examination was administered in Hawaii in December 2005. However, since that time, limiting the approved examination to only the ADEX examination has created many difficulties for dentists seeking to obtain licensure in Hawaii. For example, experienced, qualified, and competent dentists who have been practicing licensed dentistry in other states prior to 2005 and who desire to relocate and practice dentistry in Hawaii have been unable to do so because they did not take and pass the ADEX examination.
Permitting successful passage of other nationally recognized clinical dental examinations recommended by the American Dental Association or meeting certain professional qualifications as part of the licensure process will allow more dentists, whose professional competency has been clearly demonstrated in other states, to practice within the State, thereby increasing access to dental services for Hawaii residents.
The purpose of this part is to increase access to high-quality dental care in the State by allowing the board of dental examiners to accept other nationally recognized clinical dental examinations recommended by the American Dental Association or certain professional qualifications to meet licensure requirements.
SECTION 6. Section 448-9.4, Hawaii Revised Statutes, is amended to read as follows:
"§448-9.4 [American Board of Dental
Examiners (ADEX) examination; regional examinations.] Dental licensure
examination; other licensing qualifications. An applicant shall [take]:
(1) Take and pass the ADEX examination[,
and neither the state examination nor any regional examination shall be
accepted.] or any other nationally recognized clinical dental
examination recommended by the American Dental Association; or
(2) Be a practicing dentist who:
(A) Graduated from an accredited school of dentistry;
(B) Holds a license to practice dentistry in another state whose licensing requirements include passage of the ADEX examination, its predecessor examination, or another nationally recognized, substantially equivalent examination recommended by the American Dental Association;
(C) Is in good standing in the state of licensure; and
(D) Has a least five years of experience in the practice of dentistry."
PART III
SECTION 7. The legislature finds that existing law permits duly licensed and registered dentists to employ auxiliary personnel, known as dental assistants, to assist a dentist in the dentist's practice. Like dental hygienists, dental assistants are a valuable part of a dental team. However, dental assistants are not currently licensed or certified in Hawaii and are not required to meet the same stringent standards of training and care as licensed dental hygienists. The legislature notes that some concerns have been raised over proposed expansion by rule of the duties of a dental assistant and whether those duties would overlap with duties currently within the scope of practice for licensed dental hygienists.
The legislature additionally finds that it is important for those in the field of dentistry to be aware of and adhere to legislatively determined parameters regarding the duty and scope of practice for licensed dental hygienists. It is also important that unlicensed persons do not infringe upon any licensed profession's scope of practice. The legislature also finds that training and education for dental assistants are important. However, it is not appropriate for unlicensed auxiliary personnel to be expected or required to perform duties, activities, or functions that, if performed by a dental hygienist, would require licensure.
The legislature's intent is to make clear that if the board of dental examiners wishes to amend the scope of practice for licensed professionals or auxiliary personnel under the board's purview, then the board must approach the legislature, so such a change can be made in statute.
Accordingly, the purpose of this part is to clarify the allowable and prohibited practices for dental assistants.
SECTION 8. Section 448-3, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:
"(b) A duly licensed and registered
dentist may employ auxiliary personnel, other than registered dental
hygienists, to assist the dentist in executing the dentist's
practice of dentistry. These employees shall be known as dental assistants and
shall perform all duties assigned to them under the supervision, direction,
and responsibility of the dentist. [Duties] Additional duties of
the dental assistant and regulatory directives [shall] may be
delineated under rules which the board of dental examiners may from time to
time adopt[.]; provided that the rules shall not infringe upon,
overlap with, or conflict with the duties and scope of practice for any
licensed professional. No person shall employ, direct, or otherwise order a
dental assistant or other person to perform services or procedures within the
scope of practice of dental hygiene as provided in chapter 447, unless the
person who performs the services or procedures is a licensed dental hygienist
under section 447-1."
PART IV
SECTION 9. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.
SECTION 10. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 11. This Act shall take effect on July 1, 2017; provided that section 3 of this Act shall take effect on July 1, 2018.
Report Title:
Board of Dentistry and Dental Hygiene; Dentists; Dental Hygienists; Dental Licensure; Examination; Qualifications; Dental Assistants; Scope of Practice
Description:
Part I: changes the name of the board of dental examiners to the board of dentistry and dental hygiene; beginning on 7/1/2018, changes the board composition by increasing dental hygienist representation and ensuring Oahu and neighbor island representation among dental hygienist members. Part II: expands the required qualifications that applicants may fulfill as part of the requirements for dental licensure to include passage of any other nationally recognized clinical dental examination recommended by the American Dental Association and dental licensure in another state; provided that the applicant meets specific qualifications. Part III: clarifies the allowable and prohibited practices requirements for dental assistants; clarifies that rules shall not infringe upon, overlap with, or conflict with the duties and scope of practice for licensed professionals; and prohibits persons from employing, directing, or ordering a dental assistant or other person to perform services or procedures within the scope of practice of dental hygiene. (Proposed SD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
