Bill Text: OH SB327 | 2013-2014 | 130th General Assembly | Introduced

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Bill Title: To make changes to the laws governing dental professionals.

Spectrum: Moderate Partisan Bill (Republican 4-1)

Status: (Introduced - Dead) 2014-04-08 - To Commerce & Labor [SB327 Detail]

Download: Ohio-2013-SB327-Introduced.html

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As Introduced

130th General Assembly Regular Session 2013-2014

S. B. No. 327

Senator Uecker 

Cosponsors: Senators Gardner, Skindell, Hite, Lehner 

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A BILL

To amend sections 3333.61, 4715.10, 4715.13, 4715.22,

1

4715.23, 4715.363, 4715.366, 4715.371, 4715.39,

2

4715.64, and 4715.66 and to enact section 4715.421

3

of the Revised Code to make changes to the laws

4

governing dental professionals.

5

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 3333.61, 4715.10, 4715.13, 4715.22,	6
4715.23, 4715.363, 4715.366, 4715.371, 4715.39, 4715.64, and	7
4715.66 be amended and section 4715.421 of the Revised Code be	8
enacted to read as follows:	9

Sec. 3333.61.  The chancellor of the Ohio board of regents	10
shall establish and administer the Ohio innovation partnership,	11
which shall consist of the choose Ohio first scholarship program	12
and the Ohio research scholars program. Under the programs, the	13
chancellor, subject to approval by the controlling board, shall	14
make awards to state universities or colleges for programs and	15
initiatives that recruit students and scientists in the fields of	16
science, technology, engineering, mathematics, and medicine, and	17
dentistry to state universities or colleges, in order to enhance	18
regional educational and economic strengths and meet the needs of	19
the state's regional economies. Awards may be granted for programs	20
and initiatives to be implemented by a state university or college	21
alone or in collaboration with other state institutions of higher	22
education, nonpublic Ohio universities and colleges, or other	23
public or private Ohio entities. If the chancellor makes an award	24
to a program or initiative that is intended to be implemented by a	25
state university or college in collaboration with other state	26
institutions of higher education or nonpublic Ohio universities or	27
colleges, the chancellor may provide that some portion of the	28
award be received directly by the collaborating universities or	29
colleges consistent with all terms of the Ohio innovation	30
partnership.	31

The choose Ohio first scholarship program shall assign a	32
number of scholarships to state universities and colleges to	33
recruit Ohio residents as undergraduate, or as provided in section	34
3333.66 of the Revised Code graduate, students in the fields of	35
science, technology, engineering, mathematics, and medicine, and	36
dentistry, or in science, technology, engineering, mathematics, or	37
medical, or dental education. Choose Ohio first scholarships shall	38
be awarded to each participating eligible student as a grant to	39
the state university or college the student is attending and shall	40
be reflected on the student's tuition bill. Choose Ohio first	41
scholarships are student-centered grants from the state to	42
students to use to attend a university or college and are not	43
grants from the state to universities or colleges.	44

Notwithstanding any other provision of this section or	45
sections 3333.62 to 3333.69 of the Revised Code, a nonpublic	46
four-year Ohio institution of higher education may submit a	47
proposal for choose Ohio first scholarships or Ohio research	48
scholars grants. If the chancellor awards a nonpublic institution	49
scholarships or grants, the nonpublic institution shall comply	50
with all requirements of this section, sections 3333.62 to 3333.69	51
of the Revised Code, and the rules adopted under this section that	52
apply to state universities or colleges awarded choose Ohio first	53
scholarships or Ohio research scholars grants.	54

The Ohio research scholars program shall award grants to use	55
in recruiting scientists to the faculties of state universities or	56
colleges.	57

The chancellor shall adopt rules in accordance with Chapter	58
119. of the Revised Code to administer the programs.	59

Sec. 4715.10. (A) As used in this section, "accredited dental	60
college" means a dental college accredited by the commission on	61
dental accreditation or a dental college that has educational	62
standards recognized by the commission on dental accreditation and	63
is approved by the state dental board.	64

(B) Each person who desires to practice dentistry in this	65
state shall file a written application for a license with the	66
secretary of the state dental board. The application shall be on a	67
form prescribed by the board and verified by oath. Each applicant	68
shall furnish satisfactory proof to the board that the applicant	69
has met the requirements of divisions (C) and (D) of this section,	70
and if the applicant is a graduate of an unaccredited dental	71
college located outside the United States, division (E) of this	72
section.	73

(C) To be granted a license to practice dentistry, an	74
applicant must meet all of the following requirements:	75

(1) Be at least eighteen years of age;

76

(2) Be of good moral character;

77

(3) Be a graduate of an accredited dental college or of a	78
dental college located outside the United States who meets the	79
standards adopted under section 4715.11 of the Revised Code;	80

(4) Have passed parts I and II of the examination given by	81
the national board of dental examiners;	82

(5) Have passed a written jurisprudence examination	83
administered by the state dental board under division (E)(2) of	84
section 4715.03 of the Revised Code;	85

(6) Pay the fee required by division (A)(1) of section	86
4715.13 of the Revised Code.	87

(D) To be granted a license to practice dentistry, an	88
applicant must meet any one of the following requirements:	89

(1) Have taken an examination administered by any of the	90
following regional testing agencies and received on each component	91
of the examination a passing score as specified in division (A) of	92
section 4715.11 of the Revised Code: the central regional dental	93
testing service, inc., northeast regional board of dental	94
examiners, inc., the southern regional dental testing agency,	95
inc., or the western regional examining board;	96

(2) Have taken an examination administered by the state	97
dental board and received a passing score as established by the	98
board;	99

(3) Possess a license in good standing from another state and	100
have actively engaged in the legal and reputable practice of	101
dentistry in another state or in the armed forces of the United	102
States, the United States public health service, or the United	103
States department of veterans' affairs for five years immediately	104
preceding application;	105

(4) Have completed a dental residency program accredited or	106
approved by the commission on dental accreditation and	107
administered by an accredited dental college or hospital.	108

(E) To be granted a license to practice dentistry, a graduate	109
of an unaccredited dental college located outside the United	110
States must meet both of the following requirements:	111

(1) Have taken a basic science and laboratory examination	112
consistent with rules adopted under section 4715.11 of the Revised	113
Code and received a passing score as established by the board;	114

(2) Have had sufficient clinical training in an accredited	115
institution to reasonably assure a level of competency equal to	116
that of graduates of accredited dental colleges, as determined by	117
the board.	118

Sec. 4715.13. (A) Applicants for licenses to practice	119
dentistry or for a general anesthesia permit or a conscious	120
intravenous sedation permit shall pay to the secretary of the	121
state dental board the following fees:	122

(1) For license to practice dentistry, two hundred ten	123
dollars if issued in an odd-numbered year or three hundred	124
thirty-sevenfifty-seven dollars if issued in an even-numbered	125
year;	126

(2) For duplicate license, to be granted upon proof of loss	127
of the original, twenty dollars;	128

(3) For a general anesthesia permit, one hundred twenty-seven	129
dollars;	130

(4) For a conscious intravenous sedation permit, one hundred	131
twenty-seven dollars.	132

(B) TwentyForty dollars of each fee collected under division	133
(A)(1) of this section for a license issued in an even-numbered	134
year and tentwenty dollars of each fee collected under division	135
(A)(1) of this section in an odd-numbered year shall be paid to	136
the dentist loan repayment fund established under section 3702.95	137
of the Revised Code.	138

(C) In the case of a person who applies for a license to	139
practice dentistry by taking an examination administered by the	140
state dental board, both of the following apply:	141

(1) The fee in division (A)(1) of this section may be	142
refunded to an applicant who is unavoidably prevented from	143
attending the examination, or the applicant may be examined at the	144
next regular or special meeting of the board without an additional	145
fee.	146

(2) An applicant who fails the first examination may be	147
re-examined at the next regular or special meeting of the board	148
without an additional fee.	149

Sec. 4715.22.  (A)(1) This section applies only when a	150
licensed dental hygienist is not practicing under a permit issued	151
pursuant to section 4715.363 of the Revised Code authorizing	152
practice under the oral health access supervision of a dentist.	153

(2) As used in this section, "health care facility" means	154
either of the following:	155

(a) A hospital registered under section 3701.07 of the	156
Revised Code;	157

(b) A "home" as defined in section 3721.01 of the Revised	158
Code.	159

(B) A licensed dental hygienist shall practice under the	160
supervision, order, control, and full responsibility of a dentist	161
licensed under this chapter. A dental hygienist may practice in a	162
dental office, public or private school, health care facility,	163
dispensary, or public institution. Except as provided in division	164
(C) or (D) of this section, a dental hygienist may not provide	165
dental hygiene services to a patient when the supervising dentist	166
is not physically present at the location where the dental	167
hygienist is practicing.	168

(C) A dental hygienist may provide, for not more than fifteen	169
consecutive business days, dental hygiene services to a patient	170
when the supervising dentist is not physically present at the	171
location at which the services are provided if all of the	172
following requirements are met:	173

(1) The dental hygienist has at least two years and a minimum	174
of three thousand hours of experience in the practice of dental	175
hygiene.	176

(2) The dental hygienist has successfully completed a course	177
approved by the state dental board in the identification and	178
prevention of potential medical emergencies.	179

(3) The dental hygienist complies with written protocols for	180
emergencies the supervising dentist establishes for emergencies.	181

(4) The dental hygienist does not perform, while the	182
supervising dentist is absent from the location, procedures while	183
the patient is anesthetized, definitive root planing, definitive	184
subgingival curettage, or other procedures identified in rules the	185
state dental board adopts.	186

(5) The supervising dentist has evaluated the dental	187
hygienist's skills.	188

(6) The supervising dentist examined the patient not more	189
than seven monthsone year prior to the date the dental hygienist	190
provides the dental hygiene services to the patient.	191

(7) The dental hygienist complies with written protocols or	192
written standing orders that the supervising dentist establishes.	193

(8) The supervising dentist completed and evaluated a medical	194
and dental history of the patient not more than one year prior to	195
the date the dental hygienist provides dental hygiene services to	196
the patient and, except when the dental hygiene services are	197
provided in a health care facility, the supervising dentist	198
determines that the patient is in a medically stable condition.	199

(9) If the dental hygiene services are provided in a health	200
care facility, a doctor of medicine and surgery or osteopathic	201
medicine and surgery who holds a current certificate issued under	202
Chapter 4731. of the Revised Code or a registered nurse licensed	203
under Chapter 4723. of the Revised Code is present in the health	204
care facility when the services are provided.	205

(10) In advance of the appointment for dental hygiene	206
services, the patient is notified that the supervising dentist	207
will be absent from the location and that the dental hygienist	208
cannot diagnose the patient's dental health care status.	209

(11) The dental hygienist is employed by, or under contract	210
with, one of the following:	211

(a) The supervising dentist;

212

(b) A dentist licensed under this chapter who is one of the	213
following:	214

(i) The employer of the supervising dentist;

215

(ii) A shareholder in a professional association formed under	216
Chapter 1785. of the Revised Code of which the supervising dentist	217
is a shareholder;	218

(iii) A member or manager of a limited liability company	219
formed under Chapter 1705. of the Revised Code of which the	220
supervising dentist is a member or manager;	221

(iv) A shareholder in a corporation formed under division (B)	222
of section 1701.03 of the Revised Code of which the supervising	223
dentist is a shareholder;	224

(v) A partner or employee of a partnership or a limited	225
liability partnership formed under Chapter 1775. or 1776. of the	226
Revised Code of which the supervising dentist is a partner or	227
employee.	228

(c) A government entity that employs the dental hygienist to	229
provide dental hygiene services in a public school or in	230
connection with other programs the government entity administers.	231

(D) A dental hygienist may provide dental hygiene services to	232
a patient when the supervising dentist is not physically present	233
at the location at which the services are provided if the services	234
are provided as part of a dental hygiene program that is approved	235
by the state dental board and all of the following requirements	236
are met:	237

(1) The program is operated through a school district board	238
of education or the governing board of an educational service	239
center; the board of health of a city or general health district	240
or the authority having the duties of a board of health under	241
section 3709.05 of the Revised Code; a national, state, district,	242
or local dental association; or any other public or private entity	243
recognized by the state dental board.	244

(2) The supervising dentist is employed by or a volunteer	245
for, and the patients are referred by, the entity through which	246
the program is operated.	247

(3)(a) Except as provided in division (D)(3)(b) of this	248
section, the services are performed after examination and	249
diagnosis by the dentist and in accordance with the dentist's	250
written treatment plan.	251

(b) The requirement in division (D)(3)(a) of this section	252
does not apply when the only service to be provided by the dental	253
hygienist is the placement of pit and fissure sealants.	254

(E) No person shall do either of the following:

255

(1) Practice dental hygiene in a manner that is separate or	256
otherwise independent from the dental practice of a supervising	257
dentist;	258

(2) Establish or maintain an office or practice that is	259
primarily devoted to the provision of dental hygiene services.	260

(F) The state dental board shall adopt rules under division	261
(C) of section 4715.03 of the Revised Code identifying procedures	262
a dental hygienist may not perform when practicing in the absence	263
of the supervising dentist pursuant to division (C) or (D) of this	264
section. The board shall not identify the re-cementation of	265
temporary crowns as one of those procedures.	266

Sec. 4715.23.  The practice of a dental hygienist shall	267
consist of those prophylactic, preventive, and other procedures	268
that licensed dentists are authorized by this chapter and rules of	269
the dental board to assign only to licensed dental hygienists or	270
to qualified personnel under section 4715.39 of the Revised Code.	271

Licensed dentists may assign to dental hygienists intraoral	272
tasks that do not require the professional competence or skill of	273
the licensed dentist and that are authorized by board rule. Such	274
performance of intraoral tasks by dental hygienists shall be under	275
supervision and full responsibility of the licensed dentist, and	276
at no time shall more than threefour dental hygienists be	277
practicing clinical hygiene under the supervision of the same	278
dentist. The foregoing shall not be construed as authorizing the	279
assignment of diagnosis, treatment planning and prescription	280
(including prescriptions for drugs and medicaments or	281
authorizations for restorative, prosthodontic, or orthodontic	282
appliances); or, except when done in conjunction with the removal	283
of calcarious deposits, dental cement, or accretions on the crowns	284
and roots of teeth, surgical procedures on hard and soft tissues	285
within the oral cavity or any other intraoral procedure that	286
contributes to or results in an irremediable alteration of the	287
oral anatomy; or the making of final impressions from which casts	288
are made to construct any dental restoration.	289

The state dental board shall issue rules defining the	290
procedures that may be performed by licensed dental hygienists	291
engaged in school health activities or employed by public	292
agencies.	293

Sec. 4715.363. (A) A dental hygienist who desires to	294
participate in the oral health access supervision program shall	295
apply to the state dental board for a permit to practice under the	296
oral health access supervision of a dentist. The application shall	297
be under oath, on a form prescribed by the board in rules adopted	298
under section 4715.372 of the Revised Code, and accompanied by an	299
application fee of twenty dollars, which may be paid by personal	300
check.	301

(B) The applicant shall provide evidence satisfactory to the	302
board that the applicant has done all of the following:	303

(1) Completed at least two years and attained a minimum of	304
three thousand hours of experience in the practice of dental	305
hygiene;	306

(2) Completed at least twenty-four hours of continuing dental	307
hygiene education during the two years prior to submission of the	308
application;	309

(3) Completed a course pertaining to the practice of dental	310
hygiene under the oral health access supervision of a dentist that	311
meets standards established in rules adopted under section	312
4715.372 of the Revised Code;	313

(4) Completed, during the two years prior to submission of	314
the application, a course pertaining to the identification and	315
prevention of potential medical emergencies that is the same as	316
the course described in division (C)(2) of section 4715.22 of the	317
Revised Code.	318

(C) The state dental board shall issue a permit to practice	319
under the oral health access supervision of a dentist to a dental	320
hygienist who is in good standing with the board and meets all of	321
the requirements of divisions (A) and (B) of this section.	322

Sec. 4715.366. (A) A dental hygienist providing dental	323
hygiene services under a permit issued under section 4715.363 of	324
the Revised Code to practice under the oral health access	325
supervision of a dentist shall do both of the following:	326

(1) Comply with written protocols established by the	327
authorizing dentist who authorizes the dental hygienist's	328
provision of services and standing orders established by the	329
authorizing dentist, including protocols and standing orders	330
regarding emergencies and, for the purpose of section 4715.365 of	331
the Revised Code, protocols regarding what constitutes a medically	332
significant change to a patient's medical or dental history;	333

(2) Immediately following the completion of the dental	334
hygiene services and subject to division (B) of this section,	335
direct the patient to the authorizinga dentist for a clinical	336
evaluation and schedule or cause to be scheduled an appointment	337
for the patient with the authorizing dentist.	338

(B) For purposes of division (A)(2) of this section, the	339
dental hygienist shall make every attempt to schedule the	340
patient's appointment with the authorizing dentist not later than	341
ninety dayssix months after the completion of the dental hygiene	342
services. The dental hygienist shall provide the patient with a	343
written notice of the appointment that includes, at a minimum, the	344
authorizing dentist's name, address, and telephone number; the	345
date and time of the appointment; and a statement of the dental	346
hygiene services performed by the hygienist. The notice shall be	347
given to the patient or the patient's representative and one copy	348
shall be given to the authorizing dentist.	349

Sec. 4715.371. The state dental board shall develop and	350
publish on its internet web site a directory containing the names	351
and contact information, including electronic mail addresses, of	352
dentists and dental hygienists who hold current, valid permits	353
issued under sections 4715.362 and 4715.363 of the Revised Code.	354

Sec. 4715.39.  (A) The state dental board may define the	355
duties that may be performed by dental assistants and other	356
individuals designated by the board as qualified personnel. If	357
defined, the duties shall be defined in rules adopted in	358
accordance with Chapter 119. of the Revised Code. The rules may	359
include training and practice standards for dental assistants and	360
other qualified personnel. The standards may include examination	361
and issuance of a certificate. If the board issues a certificate,	362
the recipient shall display the certificate in a conspicuous	363
location in any office in which the recipient is employed to	364
perform the duties authorized by the certificate.	365

(B) A dental assistant may polish the clinical crowns of	366
teeth if all of the following requirements are met:	367

(1) The dental assistant's polishing activities are limited	368
to the use of a rubber cup attached to a slow-speed rotary dental	369
hand piece to remove soft deposits that build up over time on the	370
crowns of teeth.	371

(2) The polishing is performed only after a dentist has	372
evaluated the patient and any calculus detected on the teeth to be	373
polished has been removed by a dentist or dental hygienist.	374

(3) The dentist supervising the assistant supervises not more	375
than two dental assistants engaging in polishing activities at any	376
given time.	377

(4) The dental assistant is certified by the dental assisting	378
national board or the Ohio commission on dental assistant	379
certification.	380

(5) The dental assistant receives a certificate from the	381
board authorizing the assistant to engage in the polishing	382
activities. The board shall issue the certificate if the	383
individual has successfully completed training in the polishing of	384
clinical crowns through a program accredited by the American	385
dental association commission on dental accreditation or	386
equivalent training approved by the board. The training shall	387
include courses in basic dental anatomy and infection control,	388
followed by a course in coronal polishing that includes didactic,	389
preclinical, and clinical training; any other training required by	390
the board; and a skills assessment that includes successful	391
completion of standardized testing. The board shall adopt rules	392
pursuant to division (A) of this section establishing standards	393
for approval of this training.	394

(C) A dental assistant may apply pit and fissure sealants if	395
all of the following requirements are met:	396

(1) A dentist evaluates the patient and designates the teeth	397
and surfaces that will benefit from the application of sealant on	398
the day the application is to be performed.	399

(2) The dental assistant is certified by the dental assisting	400
national board or the Ohio commission on dental assistant	401
certification.	402

(3) The dental assistant has successfully completed a course	403
in the application of sealants consisting of at least two hours of	404
didactic instruction and six hours of clinical instruction through	405
a program provided by an institution accredited by the American	406
dental association commission on dental accreditation or a program	407
provided by a sponsor of continuing education approved by the	408
board.	409

(4) The dentist supervising the assistant has observed the	410
assistant successfully apply at least six sealants.	411

(5) TheExcept as provided in division (D) or (E) of this	412
section, the dentist supervising the assistant checks and approves	413
the application of all sealants placed by the assistant before the	414
patient leaves the location where the sealant application	415
procedure is performed.	416

(D)(1) A dental assistant who is certified by the dental	417
assisting national board or the Ohio commission on dental	418
assistant certification may provide, for not more than fifteen	419
consecutive business days, all of the following services to a	420
patient when the supervising dentist is not physically present at	421
the location where the services are provided if the conditions	422
specified in division (D)(2) of this section have been satisfied:	423

(a) The re-cementation of temporary crowns;

424

(b) The application of topical fluoride;

425

(c) The application of fluoride varnish;

426

(d) The application of disclosing solutions;

427

(e) The application of desensitizing agents;

428

(f) Carries susceptibility testing;

429

(g) The demonstration of oral hygiene procedures, including	430
the use of toothbrushes and dental floss;	431

(h) The discussion of proper nutrition.

432

(2) The conditions that must be satisfied before a dental	433
assistant may provide the services specified in division (D)(1) of	434
this section are all of the following:	435

(a) The dental assistant has at least two years and a minimum	436
of three thousand hours of experience practicing as a dental	437
assistant.	438

(b) The dental assistant has successfully completed a course	439
approved by the state dental board in the identification and	440
prevention of potential medical emergencies.	441

(c) The supervising dentist has evaluated the dental	442
assistant's skills.	443

(d) The supervising dentist examined the patient not more	444
than one year prior to the date that the dental assistant provides	445
the services to the patient.	446

(e) The supervising dentist has established written protocols	447
or written standing orders for the dental assistant to follow	448
during and in the absence of an emergency.	449

(f) The supervising dentist completed and evaluated a medical	450
and dental history of the patient not more than one year prior to	451
the date that the dental assistant provides services to the	452
patient and, except when the services are provided in a health	453
care facility, the supervising dentist determines that the patient	454
is in a medically stable condition.	455

(g) If the services are provided in a health care facility, a	456
doctor of medicine and surgery or osteopathic medicine and surgery	457
who holds a current certificate issued under Chapter 4731. of the	458
Revised Code or a registered nurse licensed under Chapter 4723. of	459
the Revised Code is present in the health care facility when the	460
services are provided.	461

(h) The patient is notified, in advance of the appointment	462
for services, that the supervising dentist will be absent from the	463
location and that the dental assistant cannot diagnose the	464
patient's dental health care status.	465

(i) The dental assistant is employed by, or under contract	466
with, the supervising dentist, a dentist licensed under this	467
chapter who meets one of the criteria specified in division	468
(C)(11)(b) of section 4715.22 of the Revised Code, or a government	469
entity that employs the dental assistant to provide services in a	470
public school or in connection with other programs the government	471
entity administers.	472

(3) A dental assistant who is certified by the dental	473
assisting national board or the Ohio commission on dental	474
assistant certification may apply, for not more than fifteen	475
business days, pit and fissure sealants when the supervising	476
dentist is not physically present at the location where the	477
sealants are to be applied if the dental assistant meets the	478
requirements in divisions (C)(3) and (4) of this section and all	479
of the conditions specified in division (D)(2) of this section	480
have been satisfied.	481

(E) A dental assistant who is certified by the dental	482
assisting national board or the Ohio commission on dental	483
assistant certification may apply pit and fissure sealants prior	484
to a dentist examining the patient and rendering a diagnosis, and	485
when a dentist is not physically present at the location where the	486
service is provided, if all of the following are the case:	487

(1) The dental assistant meets the requirements in divisions	488
(C)(3) and (4) of this section.	489

(2) All of the conditions specified in division (D)(2) of	490
this section have been satisfied.	491

(3) The dental assistant is providing the service as part of	492
a program operated through any of the following: a school district	493
board of education or the governing board of an educational	494
service center; the board of health of a city or general health	495
district or the authority having the duties of a board of health	496
under section 3709.05 of the Revised Code; a national, state,	497
district, or local dental association; or any other public or	498
private entity recognized by the state dental board.	499

(4) A supervising dentist for the program described in	500
division (E)(3) of this section meets both of the following	501
conditions:	502

(a) Is employed by or a volunteer for, and the patients are	503
referred by, the entity through which the program is operated;	504

(b) Is available for consultation by telephone,	505
videoconferencing, or other means of electronic communication.	506

(5) The application of pit and fissure sealants is limited to	507
erupted permanent posterior teeth without suspicion of cavitation.	508

(6) If the patient is a minor, a parent, guardian, or other	509
person responsible for the patient has been notified that a	510
dentist will not be present at the location and that the dental	511
assistant is not trained to diagnose or treat other serious dental	512
concerns that could exist.	513

(F) Subject to this section and the applicable rules of the	514
board, licensed dentists may assign to dental assistants and other	515
qualified personnel dental procedures that do not require the	516
professional competence or skill of the licensed dentist, a dental	517
hygienist, or an expanded function dental auxiliary as this	518
section or the board by rule authorizes dental assistants and	519
other qualified personnel to perform. TheExcept as provided in	520
division (D) or (E) of this section, the performance of dental	521
procedures by dental assistants and other qualified personnel	522
shall be under direct supervision and full responsibility of the	523
licensed dentist.	524

(E)(G) Nothing in this section shall be construed by rule of	525
the state dental board or otherwise to do the following:	526

(1) Authorize dental assistants or other qualified personnel	527
to engage in the practice of dental hygiene as defined by sections	528
4715.22 and 4715.23 of the Revised Code or to perform the duties	529
of a dental hygienist, including the removal of calcarious	530
deposits, dental cement, or accretions on the crowns and roots of	531
teeth other than as authorized pursuant to this section;	532

(2) Authorize dental assistants or other qualified personnel	533
to engage in the practice of an expanded function dental auxiliary	534
as specified in section 4715.64 of the Revised Code or to perform	535
the duties of an expanded function dental auxiliary other than as	536
authorized pursuant to this section.	537

(3) Authorize the assignment of any of the following:

538

(a) Diagnosis;

539

(b) Treatment planning and prescription, including	540
prescription for drugs and medicaments or authorization for	541
restorative, prosthodontic, or orthodontic appliances;	542

(c) Surgical procedures on hard or soft tissue of the oral	543
cavity, or any other intraoral procedure that contributes to or	544
results in an irremediable alteration of the oral anatomy;	545

(d) The making of final impressions from which casts are made	546
to construct any dental restoration.	547

(F)(H) No dentist shall assign any dental assistant or other	548
individual acting in the capacity of qualified personnel to	549
perform any dental procedure that the assistant or other	550
individual is not authorized by this section or by board rule to	551
perform. No dental assistant or other individual acting in the	552
capacity of qualified personnel shall perform any dental procedure	553
other than in accordance with this section and any applicable	554
board rule or any dental procedure that the assistant or other	555
individual is not authorized by this section or by board rule to	556
perform.	557

Sec. 4715.421. (A) As used in this section, "operation" has	558
the same meaning as in section 2305.234 of the Revised Code.	559

(B) Within thirty days after receiving an application for a	560
temporary volunteer's certificate that includes all of the items	561
listed in divisions (C)(1) and (2) of this section, the state	562
dental board shall issue, without examination, a temporary	563
volunteer's certificate to a person not licensed under this	564
chapter so that the person may provide dental services in this	565
state as a volunteer.	566

(C) An application for a temporary volunteer's certificate	567
shall include both of the following:	568

(1) A copy of the applicant's degree from a dental college or	569
dental hygiene school;	570

(2) One of the following, as applicable:

571

(a) Evidence satisfactory to the board that the applicant	572
holds a valid, unrestricted license to practice dentistry or	573
dental hygiene issued by a jurisdiction in the United States that	574
licenses persons to practice dentistry or dental hygiene;	575

(b) Evidence satisfactory to the board that the applicant is	576
practicing dentistry or dental hygiene in one or more branches of	577
the United States armed services.	578

(D) The holder of a temporary volunteer's certificate shall	579
not accept any form of remuneration for providing dental services	580
pursuant to the certificate. Except in a dental emergency, the	581
holder shall not perform any operation. The board may revoke a	582
temporary volunteer's certificate on receiving proof satisfactory	583
to the board that the holder has engaged in practice in this state	584
outside the scope of the holder's certificate or that there are	585
grounds for action against the person under section 4715.30 of the	586
Revised Code.	587

(E)(1) A temporary volunteer's certificate shall be valid for	588
a period of seven days, and may be renewed upon the application of	589
the holder, unless the certificate was previously revoked under	590
division (D) of this section. The board shall maintain a register	591
of all persons who hold a temporary volunteer's certificate. The	592
board may charge a fee not to exceed twenty-five dollars for	593
issuing or renewing a certificate pursuant to this section.	594

(2) The board shall issue to each person who qualifies under	595
this section for a temporary volunteer's certificate a wallet	596
certificate that states that the certificate holder is authorized	597
to provide dental services pursuant to the laws of this state. The	598
holder shall keep the wallet certificate on the holder's person	599
while providing dental services.	600

(3) The holder of a temporary volunteer's certificate issued	601
pursuant to this section is subject to the immunity provisions in	602
section 2305.234 of the Revised Code.	603

(F) The board shall adopt rules in accordance with Chapter	604
119. of the Revised Code to administer and enforce this section.	605

(G) Not later than ninety days after the effective date of	606
this section, the state dental board shall make available through	607
the board's internet web site the application form for a temporary	608
volunteer's certificate under this section, a description of the	609
application process, and a list of all items that are required by	610
division (C) of this section to be submitted with the application.	611

Sec. 4715.64. (A) TheSubject to divisions (B), (C), and (D)	612
of this section, the practice of an expanded function dental	613
auxiliary shall consist of the following:	614

(1) The procedures involved in the placement of restorative	615
materials limited to amalgam restorative materials and	616
non-metallicnonmetallic restorative materials, including	617
direct-bonded restorative materials;	618

(2) The procedures involved in the placement ofapplication	619
of pit and fissure sealants;	620

(3) The re-cementation of temporary crowns;

621

(4) The application of topical fluoride;

622

(5) The application of fluoride varnish;

623

(6) The application of disclosing solutions;

624

(7) The application of desensitizing agents;

625

(8) Carries susceptibility testing;

626

(9) The demonstration of oral hygiene procedures, including	627
the use of toothbrushes and dental floss;	628

(10) The discussion of proper nutrition;

629

(11) Any additional procedures authorized by the state dental	630
board in rules adopted under section 4715.66 of the Revised Code.	631

(B) An expanded function dental auxiliary shall practice	632
perform the services specified in divisions (A)(1) and (11) of	633
this section only under the direct supervision, order, control,	634
and full responsibility of a dentist licensed under this chapter.	635
At no time shall more than two expanded function dental	636
auxiliaries be practicing as expanded function dental auxiliaries	637
under the direct supervision of the same dentist. AnExcept as	638
provided in divisions (C) and (D) of this section, an expanded	639
function dental auxiliary shall not practice as an expanded	640
function dental auxiliary when the supervising dentist is not	641
physically present at the location where the expanded function	642
dental auxiliary is practicing.	643

(C)(1) An expanded function dental auxiliary may perform, for	644
not more than fifteen consecutive business days, the services	645
specified in divisions (A)(3) to (10) of this section when the	646
supervising dentist is not physically present at the location	647
where the expanded function dental auxiliary is practicing if all	648
of the following conditions have been satisfied:	649

(a) The expanded function dental auxiliary has at least two	650
years and a minimum of three thousand hours of experience	651
practicing as an expanded function dental auxiliary.	652

(b) The expanded function dental auxiliary has successfully	653
completed a course approved by the board in the identification and	654
prevention of potential medical emergencies.	655

(c) The supervising dentist has evaluated the expanded	656
function dental auxiliary's skills.	657

(d) The supervising dentist examined the patient not more	658
than one year prior to the date that the expanded function dental	659
auxiliary provides services to the patient.	660

(e) The supervising dentist has established written protocols	661
or written standing orders for the expanded function dental	662
auxiliary to follow during and in the absence of an emergency.	663

(f) The supervising dentist completed and evaluated a medical	664
and dental history of the patient not more than one year prior to	665
the date that the expanded function dental auxiliary provides	666
services to the patient and, except when the services are provided	667
in a health care facility, the supervising dentist determines that	668
the patient is in a medically stable condition.	669

(g) If the services are provided in a health care facility, a	670
doctor of medicine and surgery or osteopathic medicine and surgery	671
who holds a current certificate issued under Chapter 4731. of the	672
Revised Code or a registered nurse licensed under Chapter 4723. of	673
the Revised Code ispresent in the health care facility when the	674
services are provided.	675

(h) In advance of the appointment for services, the patient	676
is notified that the supervising dentist will be absent from the	677
location and that the expanded function dental auxiliary cannot	678
diagnose the patient's dental health care status.	679

(i) The expanded function dental auxiliary is employed by, or	680
under contract with, the supervising dentist, a dentist licensed	681
under this chapter who meets one of the criteria specified in	682
division (C)(11)(b) of section 4715.22 of the Revised Code, or a	683
government entity that employs the expanded function dental	684
auxiliary to provide services in a public school or in connection	685
with other programs the government entity administers.	686

(2) An expanded function dental auxiliary may apply, for not	687
more than fifteen consecutive business days, pit and fissure	688
sealants when the supervising dentist is not physically present at	689
the location where the expanded function dental auxiliary is	690
practicing if all of the conditions specified in division (C)(1)	691
of this section have been satisfied and both of the following are	692
the case:	693

(a) The expanded function dental auxiliary has successfully	694
completed a course in the application of sealants consisting of at	695
least two hours of didactic instruction and six hours of clinical	696
instruction through a program provided by an institution	697
accredited by the American dental association commission on dental	698
accreditation or a program provided by a sponsor of continuing	699
education approved by the board.	700

(b) The supervising dentist has observed the expanded	701
function dental auxiliary successfully apply at least six	702
sealants.	703

(D) An expanded function dental auxiliary may apply pit and	704
fissure sealants prior to a dentist examining the patient and	705
rendering a diagnosis, and when a dentist is not physically	706
present at the location where the service is provided, if all of	707
the following are the case:	708

(1) All of the conditions specified in division (C)(1) of	709
this section have been satisfied.	710

(2) The expanded function dental auxiliary meets the	711
requirements in division (C)(2)(a) and (b) of this section.	712

(3) The expanded function dental auxiliary is providing the	713
service as part of a program operated through any of the	714
following: a school district board of education or the governing	715
board of an educational service center; the board of health of a	716
city or general health district or the authority having the duties	717
of a board of health under section 3709.05 of the Revised Code; a	718
national, state, district, or local dental association; or any	719
other public or private entity recognized by the state dental	720
board.	721

(4) A supervising dentist for the program described in	722
division (D)(3) of this section meets both of the following	723
conditions:	724

(a) Is employed by or a volunteer for, and the patients are	725
referred by, the entity through which the program is operated;	726

(b) Is available for consultation by telephone,	727
videoconferencing, or other means of electronic communication.	728

(5) The application of pit and fissure sealants is limited to	729
erupted permanent posterior teeth without suspicion of cavitation.	730

(6) If the patient is a minor, a parent, guardian, or other	731
person responsible for the patient has been notified that a	732
dentist will not be present at the location and that the expanded	733
function dental auxiliary is not trained to diagnose or treat	734
other serious dental concerns that could exist.	735

(E) Nothing in this section shall be construed by rule of the	736
board or otherwise to authorize an expanded function dental	737
auxiliary to engage in the practice of dental hygiene as defined	738
by sections 4715.22 and 4715.23 of the Revised Code.	739

Sec. 4715.66. (A) The state dental board shall adopt rules as	740
the board considers necessary to implement and administer sections	741
4715.61 to 4715.64 of the Revised Code. The rules shall be adopted	742
in accordance with Chapter 119. of the Revised Code.	743

(B) In adopting rules under this section, all of the	744
following apply:	745

(1) The board shall adopt rules specifying the education or	746
training necessary for an individual to register as an expanded	747
function dental auxiliary under this chapter.	748

(2) The board shall adopt rules specifying the standards that	749
must be met for an examination to be accepted by the board as an	750
examination of competency to practice as an expanded function	751
dental auxiliary. In specifying the standards, the board shall	752
provide that an examination will be accepted only if the entity	753
that administered the examination required an individual to be one	754
of the following as a condition of admission to the examination:	755

(a) An unlicensed dentist who has graduated from an	756
accredited dental college, as specified in section 4715.10 of the	757
Revised Code, and does not have a dental license under suspension	758
or revocation by the board;	759

(b) A dental student who is enrolled in an accredited dental	760
college, as specified in section 4715.10 of the Revised Code, and	761
is considered by the dean of the college to be in good standing as	762
a dental student;	763

(c) A graduate of a dental college located outside of the	764
United States;	765

(d) A dental assistant who is certified by the dental	766
assisting national board or the Ohio commission on dental	767
assistant certification;	768

(e) A dental hygienist licensed under this chapter whose	769
license is in good standing;	770

(f) An unlicensed dental hygienist who has graduated from an	771
accredited dental hygiene school, as specified in section 4715.21	772
of the Revised Code, and does not have a dental hygienist license	773
under suspension or revocation by the board.	774

(3) The board may adopt rules specifying procedures an	775
expanded function dental auxiliary may perform that are in	776
addition to the procedures specified in divisions (A)(1) and (2)	777
to (10) of section 4715.64 of the Revised Code.	778

Section 2.  That existing sections 3333.61, 4715.10, 4715.13,	779
4715.22, 4715.23, 4715.363, 4715.366, 4715.371, 4715.39, 4715.64,	780
and 4715.66 of the Revised Code are hereby repealed.	781

Section 3. (A) There is hereby created the Medicaid Payment	782
Rates for Dental Services Workgroup. The Workgroup shall consist	783
of all of the following:	784

(1) The Medicaid Director or the Director's designee;

785

(2) The Director of Health or the Director's designee;

786

(3) Two members of the Senate, one from the majority party	787
and the other from the minority party, appointed by the President	788
of the Senate;	789

(4) Two members of the House of Representatives, one from the	790
majority party and the other from the minority party, appointed by	791
the Speaker of the House of Representatives;	792

(5) Four dentists who have valid Medicaid provider agreements	793
and practice in different geographic areas of the state, appointed	794
by the executive director of the Ohio Dental Association.	795

(B) Appointments to the Workgroup shall be made not later	796
than thirty days after the effective date of this section. Except	797
to the extent that serving on the Workgroup is part of a member's	798
regular employment duties, a member of the Workgroup shall not be	799
paid for the member's service on the Workgroup. Members of the	800
Workgroup shall not be reimbursed for their expenses incurred in	801
serving on the Workgroup.	802

(C) The Medicaid Director or Director's designee shall serve	803
as the Workgroup's chairperson. The Workgroup shall meet at the	804
call of the chairperson.	805

(D) The Department of Medicaid shall provide staff and other	806
support services for the Workgroup.	807

(E) The Workgroup shall study the issue of Medicaid payment	808
rates for dental services. Not later than December 31, 2014, the	809
Workgroup shall submit a report of its study to the Governor and,	810
in accordance with section 101.68 of the Revised Code, the General	811
Assembly. The report shall include recommendations regarding	812
Medicaid payment rates for dental services. The Workgroup shall	813
cease to exist on submission of its report.	814

Section 4. Not later than July 1, 2015, the Development	815
Services Agency shall enter into a contract with JobsOhio. This	816
contract shall specify that JobsOhio shall use $250,000 in the	817
fiscal year ending June 30, 2016, to provide no-interest loans for	818
the purchase of dental equipment to be used for the treatment of	819
underserved populations in dental health resource shortage areas	820
designated by the Director of Health under section 3702.87 of the	821
Revised Code. The Development Services Agency shall coordinate	822
duties with JobsOhio through this contract.	823