HF 1226

as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:46am

A bill for an act
relating to health occupations; establishing licensure and practice limitations for
an oral health practitioner; establishing fees; requiring rulemaking; amending
Minnesota Statutes 2008, sections 150A.01, by adding a subdivision; 150A.05,
subdivision 2, by adding a subdivision; 150A.06, subdivisions 2d, 5, 6, by
adding subdivisions; 150A.08, subdivisions 1, 3a, 5; 150A.09, subdivisions 1, 3;
150A.091, subdivisions 2, 3, 5, 8, 10; 150A.10, subdivisions 2, 3, 4; 150A.11,
subdivision 4; 150A.12; 150A.21, subdivisions 1, 4; 151.01, subdivision 23;
151.37, subdivision 2; proposing coding for new law in Minnesota Statutes,
chapter 150A; repealing Minnesota Statutes 2008, section 150A.061.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2008, section 150A.01, is amended by adding a
subdivision to read:

new text begin Subd. 6b. new text end

new text begin Oral health practitioner. new text end

new text begin "Oral health practitioner" means a person
licensed under this chapter to perform the services authorized under section 150A.105 or
any other services authorized under this chapter.
new text end

Sec. 2.

Minnesota Statutes 2008, section 150A.05, is amended by adding a subdivision
to read:

new text begin Subd. 1b. new text end

new text begin Practice of oral health practitioners. new text end

new text begin A person shall be deemed to be
practicing as an oral health practitioner within the meaning of this chapter who:
new text end

new text begin (1) works under the supervision of a Minnesota-licensed dentist under a collaborative
management agreement as specified under section 150A.105;
new text end

new text begin (2) practices in settings that serve low-income, uninsured, and underserved patients
or are located in dental health professional shortage areas; and
new text end

new text begin (3) provides oral health care services, including preventive, primary diagnostic,
educational, palliative, therapeutic, and restorative services as authorized under section
150A.105 and within the context of a collaborative management agreement.
new text end

Sec. 3.

Minnesota Statutes 2008, section 150A.05, subdivision 2, is amended to read:

Subd. 2.

Exemptions and exceptions of certain practices and operations.

Sections 150A.01 to 150A.12 do not apply to:

(1) the practice of dentistry or dental hygiene in any branch of the armed services of
the United States, the United States Public Health Service, or the United States Veterans
Administration;

(2) the practice of dentistry, dental hygiene, or dental assisting by undergraduate
dental students, new text begin oral health practitioner students, new text end dental hygiene students, and dental
assisting students of the University of Minnesota, schools of dental hygiene, new text begin schools
with an oral health practitioner education program accredited under section 150A.06, new text end or
schools of dental assisting approved by the board, when acting under the direction and
supervision of a licensed dentist new text begin , a licensed oral health practitioner, new text end or a licensed dental
hygienist acting as an instructor;

(3) the practice of dentistry by licensed dentists of other states or countries while
appearing as clinicians under the auspices of a duly approved dental school or college, or a
reputable dental society, or a reputable dental study club composed of dentists;

(4) the actions of persons while they are taking examinations for licensure or
registration administered or approved by the board pursuant to sections 150A.03,
subdivision 1, and 150A.06, subdivisions 1, 2, and 2a;

(5) the practice of dentistry by dentists and dental hygienists licensed by other states
during their functioning as examiners responsible for conducting licensure or registration
examinations administered by regional and national testing agencies with whom the
board is authorized to affiliate and participate under section 150A.03, subdivision 1,
and the practice of dentistry by the regional and national testing agencies during their
administering examinations pursuant to section 150A.03, subdivision 1;

(6) the use of X-rays or other diagnostic imaging modalities for making radiographs
or other similar records in a hospital under the supervision of a physician or dentist or
by a person who is credentialed to use diagnostic imaging modalities or X-ray machines
for dental treatment, roentgenograms, or dental diagnostic purposes by a credentialing
agency other than the Board of Dentistry; or

(7) the service, other than service performed directly upon the person of a patient, of
constructing, altering, repairing, or duplicating any denture, partial denture, crown, bridge,
splint, orthodontic, prosthetic, or other dental appliance, when performed according to
a written work order from a licensed dentist new text begin or a licensed oral health practitioner new text end in
accordance with section 150A.10, subdivision 3.

Sec. 4.

Minnesota Statutes 2008, section 150A.06, is amended by adding a subdivision
to read:

new text begin Subd. 1d. new text end

new text begin Oral health practitioners. new text end

new text begin A person, of good moral character who has
graduated from an oral health practitioner education program that has been approved
by the board or accredited by the Commission on Dental Accreditation or another
board-approved national accreditation organization, may apply for licensure.
new text end

new text begin The applicant must submit an application and fee as prescribed by the board and
a diploma or certificate from an oral health practitioner education program. Prior to
being licensed, the applicant must pass a comprehensive, competency-based clinical
examination that is approved by the board and administered independently of an institution
providing oral health practitioner education. The applicant must also pass an examination
testing the applicant's knowledge of the Minnesota laws and rules relating to the practice
of dentistry. An applicant who has failed the clinical examination twice is ineligible
to retake the clinical examination until further education and training are obtained as
specified in rules adopted by the board. A separate, nonrefundable fee may be charged for
each time a person applies. An applicant who passes the examination in compliance with
subdivision 2b, abides by professional ethical conduct requirements, and meets all the
other requirements of the board shall be licensed as an oral health practitioner.
new text end

Sec. 5.

Minnesota Statutes 2008, section 150A.06, is amended by adding a subdivision
to read:

new text begin Subd. 1e. new text end

new text begin Resident dental providers. new text end

new text begin A person who is a graduate of an
undergraduate program and is an enrolled graduate student of an advanced dental
education program shall obtain from the board a license to practice as a resident dental
hygienist or oral health practitioner. The license must be designated "resident dental
provider license" and authorizes the licensee to practice only under the supervision of a
licensed dentist or licensed oral health practitioner. A resident dental provider license
must be renewed annually according to rules adopted by the board. An applicant for a
resident dental provider license shall pay a nonrefundable fee set by the board for issuing
and renewing the license. The requirements of sections 150A.01 to 150A.21 apply to
resident dental providers except as specified in rules adopted by the board. A resident
dental provider license does not qualify a person for licensure under subdivision 1d or 2.
new text end

Sec. 6.

Minnesota Statutes 2008, section 150A.06, subdivision 2d, is amended to read:

Subd. 2d.

Continuing education and professional development waiver.

(a)
The board shall grant a waiver to the continuing education requirements under this
chapter for a licensed dentist, new text begin licensed oral health practitioner, new text end licensed dental hygienist,
or registered dental assistant who documents to the satisfaction of the board that the
dentist, new text begin oral health practitioner, new text end dental hygienist, or registered dental assistant has retired
from active practice in the state and limits the provision of dental care services to those
offered without compensation in a public health, community, or tribal clinic or a nonprofit
organization that provides services to the indigent or to recipients of medical assistance,
general assistance medical care, or MinnesotaCare programs.

(b) The board may require written documentation from the volunteer and retired
dentist, new text begin oral health practitioner, new text end dental hygienist, or registered dental assistant prior
to granting this waiver.

(c) The board shall require the volunteer and retired dentist, new text begin oral health practitioner,
new text end dental hygienist, or registered dental assistant to meet the following requirements:

(1) a licensee or registrant seeking a waiver under this subdivision must complete
and document at least five hours of approved courses in infection control, medical
emergencies, and medical management for the continuing education cycle; and

(2) provide documentation of certification in advanced or basic cardiac life support
recognized by the American Heart Association, the American Red Cross, or an equivalent
entity.

Sec. 7.

Minnesota Statutes 2008, section 150A.06, subdivision 5, is amended to read:

Subd. 5.

Fraud in securing licenses or registrations.

Every person implicated
in employing fraud or deception in applying for or securing a license or registration to
practice dentistry, dental hygiene, or dental assisting new text begin , or as an oral health practitioner new text end or in
annually renewing a license or registration under sections 150A.01 to 150A.12 is guilty
of a gross misdemeanor.

Sec. 8.

Minnesota Statutes 2008, section 150A.06, subdivision 6, is amended to read:

Subd. 6.

Display of name and certificates.

The initial license and subsequent
renewal, or current registration certificate, of every dentist, new text begin oral health practitioner, new text end dental
hygienist, or dental assistant shall be conspicuously displayed in every office in which that
person practices, in plain sight of patients. Near or on the entrance door to every office
where dentistry is practiced, the name of each dentist practicing there, as inscribed on the
current license certificate, shall be displayed in plain sight.

Sec. 9.

Minnesota Statutes 2008, section 150A.08, subdivision 1, is amended to read:

Subdivision 1.

Grounds.

The board may refuse or by order suspend or revoke,
limit or modify by imposing conditions it deems necessary, deleted text begin any deleted text end new text begin the new text end license deleted text begin to practice
dentistry or dental hygiene deleted text end new text begin of a dentist, oral health practitioner, or dental hygienist, new text end or the
registration of any dental assistant upon any of the following grounds:

(1) fraud or deception in connection with the practice of dentistry or the securing of
a license or registration certificate;

(2) conviction, including a finding or verdict of guilt, an admission of guilt, or a no
contest plea, in any court of a felony or gross misdemeanor reasonably related to the
practice of dentistry as evidenced by a certified copy of the conviction;

(3) conviction, including a finding or verdict of guilt, an admission of guilt, or a
no contest plea, in any court of an offense involving moral turpitude as evidenced by a
certified copy of the conviction;

(4) habitual overindulgence in the use of intoxicating liquors;

(5) improper or unauthorized prescription, dispensing, administering, or personal
or other use of any legend drug as defined in chapter 151, of any chemical as defined in
chapter 151, or of any controlled substance as defined in chapter 152;

(6) conduct unbecoming a person licensed to practice dentistry or dental hygiene
new text begin or as an oral health practitioner new text end or registered as a dental assistant, or conduct contrary to
the best interest of the public, as such conduct is defined by the rules of the board;

(7) gross immorality;

(8) any physical, mental, emotional, or other disability which adversely affects a
dentist's, new text begin oral health practitioner's, new text end dental hygienist's, or registered dental assistant's ability
to perform the service for which the person is licensed or registered;

(9) revocation or suspension of a license, registration, or equivalent authority to
practice, or other disciplinary action or denial of a license or registration application taken
by a licensing, registering, or credentialing authority of another state, territory, or country
as evidenced by a certified copy of the licensing authority's order, if the disciplinary action
or application denial was based on facts that would provide a basis for disciplinary action
under this chapter and if the action was taken only after affording the credentialed person
or applicant notice and opportunity to refute the allegations or pursuant to stipulation
or other agreement;

(10) failure to maintain adequate safety and sanitary conditions for a dental office in
accordance with the standards established by the rules of the board;

(11) employing, assisting, or enabling in any manner an unlicensed person to
practice dentistry;

(12) failure or refusal to attend, testify, and produce records as directed by the board
under subdivision 7;

(13) violation of, or failure to comply with, any other provisions of sections 150A.01
to 150A.12, the rules of the Board of Dentistry, or any disciplinary order issued by the
board, sections 144.291 to 144.298 or 595.02, subdivision 1, paragraph (d), or for any
other just cause related to the practice of dentistry. Suspension, revocation, modification
or limitation of any license shall not be based upon any judgment as to therapeutic or
monetary value of any individual drug prescribed or any individual treatment rendered,
but only upon a repeated pattern of conduct;

(14) knowingly providing false or misleading information that is directly related
to the care of that patient unless done for an accepted therapeutic purpose such as the
administration of a placebo; or

(15) aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:

(i) a copy of the record of criminal conviction or plea of guilty for a felony in
violation of section 609.215, subdivision 1 or 2;

(ii) a copy of the record of a judgment of contempt of court for violating an
injunction issued under section 609.215, subdivision 4;

(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5; or

(iv) a finding by the board that the person violated section 609.215, subdivision
1 or 2. The board shall investigate any complaint of a violation of section 609.215,
subdivision 1 or 2.

Sec. 10.

Minnesota Statutes 2008, section 150A.08, subdivision 3a, is amended to read:

Subd. 3a.

Costs; additional penalties.

(a) The board may impose a civil penalty
not exceeding $10,000 for each separate violation, the amount of the civil penalty to
be fixed so as to deprive a licensee or registrant of any economic advantage gained by
reason of the violation, to discourage similar violations by the licensee or registrant or any
other licensee or registrant, or to reimburse the board for the cost of the investigation and
proceeding, including, but not limited to, fees paid for services provided by the Office of
Administrative Hearings, legal and investigative services provided by the Office of the
Attorney General, court reporters, witnesses, reproduction of records, board members'
per diem compensation, board staff time, and travel costs and expenses incurred by board
staff and board members.

(b) In addition to costs and penalties imposed under paragraph (a), the board may
also:

(1) order the dentist, new text begin oral health practitioner, new text end dental hygienist, or dental assistant to
provide unremunerated service;

(2) censure or reprimand the dentist, new text begin oral health practitioner, new text end dental hygienist, or
dental assistant; or

(3) any other action as allowed by law and justified by the facts of the case.

Sec. 11.

Minnesota Statutes 2008, section 150A.08, subdivision 5, is amended to read:

Subd. 5.

Medical examinations.

If the board has probable cause to believe
that a dentist, new text begin oral health practitioner, new text end dental hygienist, registered dental assistant, or
applicant engages in acts described in subdivision 1, clause (4) or (5), or has a condition
described in subdivision 1, clause (8), it shall direct the dentist, new text begin oral health practitioner,
new text end dental hygienist, assistant, or applicant to submit to a mental or physical examination or
a chemical dependency assessment. For the purpose of this subdivision, every dentist,
new text begin oral health practitioner, new text end hygienist, or assistant licensed or registered under this chapter
or person submitting an application for a license or registration is deemed to have given
consent to submit to a mental or physical examination when directed in writing by the
board and to have waived all objections in any proceeding under this section to the
admissibility of the examining physician's testimony or examination reports on the ground
that they constitute a privileged communication. Failure to submit to an examination
without just cause may result in an application being denied or a default and final order
being entered without the taking of testimony or presentation of evidence, other than
evidence which may be submitted by affidavit, that the licensee, registrant, or applicant
did not submit to the examination. A dentist, new text begin oral health practitioner, new text end dental hygienist,
registered dental assistant, or applicant affected under this section shall at reasonable
intervals be afforded an opportunity to demonstrate ability to start or resume the competent
practice of dentistry or perform the duties of deleted text begin a deleted text end new text begin an oral health practitioner, new text end dental hygienist new text begin , new text end
or registered dental assistant with reasonable skill and safety to patients. In any proceeding
under this subdivision, neither the record of proceedings nor the orders entered by the
board is admissible, is subject to subpoena, or may be used against the dentist, new text begin oral health
practitioner, new text end dental hygienist, registered dental assistant, or applicant in any proceeding
not commenced by the board. Information obtained under this subdivision shall be
classified as private pursuant to the Minnesota Government Data Practices Act.

Sec. 12.

Minnesota Statutes 2008, section 150A.09, subdivision 1, is amended to read:

Subdivision 1.

Registration information and procedure.

On or before the license
or registration certificate expiration date every licensed dentist, new text begin oral health practitioner,
new text end dental hygienist, and registered dental assistant shall transmit to the executive secretary of
the board, pertinent information required by the board, together with the fee established
by the board. At least 30 days before a license or registration certificate expiration date,
the board shall send a written notice stating the amount and due date of the fee and the
information to be provided to every licensed dentist, new text begin oral health practitioner, new text end dental
hygienist, and registered dental assistant.

Sec. 13.

Minnesota Statutes 2008, section 150A.09, subdivision 3, is amended to read:

Subd. 3.

Current address, change of address.

Every dentist, new text begin oral health
practitioner, new text end dental hygienist, and registered dental assistant shall maintain with the board
a correct and current mailing address. For dentists engaged in the practice of dentistry,
the address shall be that of the location of the primary dental practice. Within 30 days
after changing addresses, every dentist, new text begin oral health practitioner, new text end dental hygienist, and
registered dental assistant shall provide the board written notice of the new address either
personally or by first class mail.

Sec. 14.

Minnesota Statutes 2008, section 150A.091, subdivision 2, is amended to read:

Subd. 2.

Application fees.

Each applicant for licensure or registration shall submit
with a license or registration application a nonrefundable fee in the following amounts in
order to administratively process an application:

(1) dentist, $140;

(2) limited faculty dentist, $140;

(3) resident dentist, $55;

(4) new text begin oral health practitioner, $100;
new text end

new text begin (5) new text end dental hygienist, $55;

deleted text begin (5) deleted text end new text begin (6) new text end registered dental assistant, $35; and

deleted text begin (6) deleted text end new text begin (7) new text end dental assistant with a limited registration, $15.

Sec. 15.

Minnesota Statutes 2008, section 150A.091, subdivision 3, is amended to read:

Subd. 3.

Initial license or registration fees.

Along with the application fee, each of
the following licensees or registrants shall submit a separate prorated initial license or
registration fee. The prorated initial fee shall be established by the board based on the
number of months of the licensee's or registrant's initial term as described in Minnesota
Rules, part 3100.1700, subpart 1a, not to exceed the following monthly fee amounts:

(1) dentist, $14 times the number of months of the initial term;

(2) new text begin oral health practitioner, $10 times the number of months of initial term;
new text end

new text begin (3) new text end dental hygienist, $5 times the number of months of the initial term;

deleted text begin (3) deleted text end new text begin (4) new text end registered dental assistant, $3 times the number of months of initial term; and

deleted text begin (4) deleted text end new text begin (5) new text end dental assistant with a limited registration, $1 times the number of months
of the initial term.

Sec. 16.

Minnesota Statutes 2008, section 150A.091, subdivision 5, is amended to read:

Subd. 5.

Biennial license or registration fees.

Each of the following licensees or
registrants shall submit with a biennial license or registration renewal application a fee as
established by the board, not to exceed the following amounts:

(1) dentist, $336;

(2) new text begin oral health practitioner, $240;
new text end

new text begin (3) new text end dental hygienist, $118;

deleted text begin (3) deleted text end new text begin (4) new text end registered dental assistant, $80; and

deleted text begin (4) deleted text end new text begin (5) new text end dental assistant with a limited registration, $24.

Sec. 17.

Minnesota Statutes 2008, section 150A.091, subdivision 8, is amended to read:

Subd. 8.

Duplicate license or registration fee.

Each licensee or registrant shall
submit, with a request for issuance of a duplicate of the original license or registration, or
of an annual or biennial renewal of it, a fee in the following amounts:

(1) original dentist new text begin , oral health practitioner,` new text end or dental hygiene license, $35; and

(2) initial and renewal registration certificates and license renewal certificates, $10.

Sec. 18.

Minnesota Statutes 2008, section 150A.091, subdivision 10, is amended to
read:

Subd. 10.

Reinstatement fee.

No dentist, new text begin oral health practitioner, new text end dental hygienist,
or registered dental assistant whose license or registration has been suspended or revoked
may have the license or registration reinstated or a new license or registration issued until
a fee has been submitted to the board in the following amounts:

(1) dentist, $140;

(2) new text begin oral health practitioner, $100;
new text end

new text begin (3) new text end dental hygienist, $55; and

deleted text begin (3) deleted text end new text begin (4) new text end registered dental assistant, $35.

Sec. 19.

Minnesota Statutes 2008, section 150A.10, subdivision 2, is amended to read:

Subd. 2.

Dental assistants.

Every licensed dentist new text begin or oral health practitioner new text end who
uses the services of any unlicensed person for the purpose of assistance in the practice of
dentistry new text begin or within the practice of an oral health practitioner new text end shall be responsible for the
acts of such unlicensed person while engaged in such assistance. deleted text begin Such deleted text end new text begin The new text end dentist new text begin or oral
health practitioner new text end shall permit deleted text begin such deleted text end new text begin the new text end unlicensed assistant to perform only those acts
which are authorized to be delegated to unlicensed assistants by the Board of Dentistry.
deleted text begin Such deleted text end new text begin The new text end acts shall be performed under supervision of a licensed dentist new text begin or licensed oral
health practitioner. A licensed oral health practitioner shall not supervise more than four
registered dental assistants at any one practice setting new text end . The board may permit differing
levels of dental assistance based upon recognized educational standards, approved by
the board, for the training of dental assistants. The board may also define by rule the
scope of practice of registered and nonregistered dental assistants. The board by rule
may require continuing education for differing levels of dental assistants, as a condition
to their registration or authority to perform their authorized duties. Any licensed dentist
new text begin or licensed oral health practitioner new text end who deleted text begin shall permit such deleted text end new text begin permits an new text end unlicensed assistant
to perform any dental service other than that authorized by the board shall be deemed to
be enabling an unlicensed person to practice dentistry, and commission of such an act by
deleted text begin such deleted text end new text begin an new text end unlicensed assistant shall constitute a violation of sections 150A.01 to 150A.12.

Sec. 20.

Minnesota Statutes 2008, section 150A.10, subdivision 3, is amended to read:

Subd. 3.

Dental technicians.

Every licensed dentist new text begin and oral health practitioner
new text end who uses the services of any unlicensed person, other than under the dentist's new text begin or oral
health practitioner's new text end supervision and within deleted text begin such dentist's own office deleted text end new text begin the same practice
setting new text end , for the purpose of constructing, altering, repairing or duplicating any denture,
partial denture, crown, bridge, splint, orthodontic, prosthetic or other dental appliance,
shall be required to furnish such unlicensed person with a written work order in such form
as shall be prescribed by the rules of the board deleted text begin ; said deleted text end new text begin . The new text end work order shall be made in
duplicate form, a duplicate copy to be retained in a permanent file deleted text begin in deleted text end new text begin of new text end the deleted text begin dentist's office deleted text end
new text begin dentist or oral health practitioner at the practice setting new text end for a period of two years, and the
original to be retained in a permanent file for a period of two years by deleted text begin such deleted text end new text begin the new text end unlicensed
person in that person's place of business. deleted text begin Such deleted text end new text begin The new text end permanent file of work orders to be
kept by deleted text begin such deleted text end new text begin the new text end dentist new text begin , oral health practitioner, new text end or by deleted text begin such deleted text end new text begin the new text end unlicensed person shall be
open to inspection at any reasonable time by the board or its duly constituted agent.

Sec. 21.

Minnesota Statutes 2008, section 150A.10, subdivision 4, is amended to read:

Subd. 4.

Restorative procedures.

(a) Notwithstanding subdivisions 1, 1a, and 2,
a licensed dental hygienist or a registered dental assistant may perform the following
restorative procedures:

(1) place, contour, and adjust amalgam restorations;

(2) place, contour, and adjust glass ionomer;

(3) adapt and cement stainless steel crowns; and

(4) place, contour, and adjust class I and class V supragingival composite restorations
where the margins are entirely within the enamel.

(b) The restorative procedures described in paragraph (a) may be performed only if:

(1) the licensed dental hygienist or the registered dental assistant has completed a
board-approved course on the specific procedures;

(2) the board-approved course includes a component that sufficiently prepares the
dental hygienist or registered dental assistant to adjust the occlusion on the newly placed
restoration;

(3) a licensed dentist new text begin or licensed oral health practitioner new text end has authorized the procedure
to be performed; and

(4) a licensed dentist new text begin or licensed oral health practitioner new text end is available in the clinic
while the procedure is being performed.

(c) The dental faculty who teaches the educators of the board-approved courses
specified in paragraph (b) must have prior experience teaching these procedures in an
accredited dental education program.

Sec. 22.

new text begin [150A.105] ORAL HEALTH PRACTITIONER.
new text end

new text begin Subdivision 1. new text end

new text begin General. new text end

new text begin An oral health practitioner licensed under this chapter
may practice under the supervision of a Minnesota-licensed dentist pursuant to a written
collaborative management agreement and the requirements of this chapter.
new text end

new text begin Subd. 2. new text end

new text begin Limited practice settings. new text end

new text begin An oral health practitioner licensed under this
chapter is limited to primarily practicing in settings that serve low-income, uninsured, and
underserved patients or are located in a dental health professional shortage area.
new text end

new text begin Subd. 3. new text end

new text begin Collaborative management agreement. new text end

new text begin (a) Prior to performing any of
the services authorized under this chapter, an oral health practitioner must enter into
a written collaborative management agreement with a Minnesota-licensed dentist. The
agreement must include:
new text end

new text begin (1) practice settings where services may be provided and the populations to be
served;
new text end

new text begin (2) any limitations on the services that may be provided by the oral health
practitioner, including the level of supervision required by the collaborating dentist and
consultation criteria;
new text end

new text begin (3) age and procedure specific practice protocols, including case selection criteria,
examination guidelines, and imaging frequency;
new text end

new text begin (4) a procedure for creating and maintaining dental records for the patients that
are treated by the oral health practitioner;
new text end

new text begin (5) a plan to manage medical emergencies in each practice setting where the oral
health practitioner provides care;
new text end

new text begin (6) a quality assurance plan for monitoring care provided by the oral health
practitioner, including patient care review, referral follow-up, and a quality assurance
chart review;
new text end

new text begin (7) protocols for prescribing, administering, and dispensing medications authorized
under subdivision 5, including the specific conditions and circumstances under which
these medications are to be prescribed, dispensed, and administered;
new text end

new text begin (8) criteria relating to the provision of care to patients with specific medical
conditions or complex medication histories, including any requirements for consultation
prior to the initiation of care;
new text end

new text begin (9) criteria for the supervision of allied dental personnel;
new text end

new text begin (10) a plan for the provision of clinical referrals in situations that are beyond the
diagnostic or treatment capabilities of the oral health practitioner; and
new text end

new text begin (11) a description of any financial arrangement, if applicable, between the oral
health practitioner and collaborating dentist.
new text end

new text begin (b) A collaborating dentist must be licensed and practicing in Minnesota. The
collaborating dentist shall accept responsibility for all services authorized and performed
by the oral health practitioner under the collaborative management agreement. Any
licensed dentist who permits an oral health practitioner to perform a dental service other
than those authorized under this section or by the board or any oral health practitioner who
performs unauthorized services shall be in violation sections 150A.01 to 150A.12.
new text end

new text begin (c) Both the collaborating dentist and the oral health practitioner must maintain
professional liability coverage. Proof of professional liability coverage shall be submitted
to the board as part of the collaborative management agreement.
new text end

new text begin (d) Collaborative management agreements must be signed and maintained by the
collaborating dentist and the oral health practitioner. Agreements must be reviewed,
updated, and submitted to the board on an annual basis.
new text end

new text begin (e) A collaborating dentist shall accept any patient referred by the oral health
practitioner or have a referral process for patients that are referred by the oral health
practitioner.
new text end

new text begin (f) A collaborating dentist must conduct periodic oversight reviews of each oral
health practitioner in which the dentist has entered into a collaborative management
agreement.
new text end

new text begin Subd. 4. new text end

new text begin Scope of practice. new text end

new text begin (a) A licensed oral health practitioner may perform
dental services as authorized under this section within the parameters of the collaborative
management agreement.
new text end

new text begin (b) The services a licensed oral health practitioner may perform include preventive,
primary diagnostic, educational, palliative, therapeutic, and restorative oral health services
as specified in paragraphs (c) and (d), and within the parameters of the collaborative
management agreement.
new text end

new text begin (c) A licensed oral health practitioner may perform the following services under
general supervision, unless restricted or prohibited in the collaborative management
agreement:
new text end

new text begin (1) preventive, palliative, diagnostic, and assessment services:
new text end

new text begin (i) oral health instruction and disease prevention education, including nutritional
counseling and dietary analysis;
new text end

new text begin (ii) diagnostic services, including an examination, evaluation, and assessment to
identify oral disease and conditions;
new text end

new text begin (iii) formulation of a diagnosis and individualized treatment plan, including
preliminary charting of the oral cavity;
new text end

new text begin (iv) taking of radiographs;
new text end

new text begin (v) prophylaxis;
new text end

new text begin (vi) fabrication of athletic mouthguards;
new text end

new text begin (vii) application of topical preventive or prophylactic agents, including fluoride
varnishes and pit and fissure sealants;
new text end

new text begin (viii) full-mouth debridement;
new text end

new text begin (ix) emergency palliative treatment of dental pain;
new text end

new text begin (x) pulp vitality testing;
new text end

new text begin (xi) application of desensitizing medication or resin; and
new text end

new text begin (xii) space maintainer removal;
new text end

new text begin (2) restorative services:
new text end

new text begin (i) cavity preparation class I-IV;
new text end

new text begin (ii) restoration of primary and permanent teeth class I-IV;
new text end

new text begin (iii) placement of temporary crowns;
new text end

new text begin (iv) placement of temporary restorations;
new text end

new text begin (v) preparation and placement of preformed crowns;
new text end

new text begin (vi) pulpotomies on primary teeth;
new text end

new text begin (vii) indirect and direct pulp capping on primary and permanent teeth;
new text end

new text begin (viii) repair of defective prosthetic appliances;
new text end

new text begin (ix) recementing of permanent crowns;
new text end

new text begin (x) administering nitrous oxide inhalation analgesia;
new text end

new text begin (xi) administering injections of local anesthetic agents;
new text end

new text begin (xii) periodontal maintenance;
new text end

new text begin (xiii) scaling and root planing;
new text end

new text begin (xiv) soft-tissue reline and conditioning;
new text end

new text begin (xv) atraumatic restorative technique; and
new text end

new text begin (xvi) opening permanent teeth for pulpal debridement and opening chamber; and
new text end

new text begin (3) surgical services:
new text end

new text begin (i) extractions of primary and permanent teeth;
new text end

new text begin (ii) suture placement and removal;
new text end

new text begin (iii) dressing change;
new text end

new text begin (iv) brush biopsies;
new text end

new text begin (v) tooth reimplantation and stabilization; and
new text end

new text begin (vi) abscess incision and drainage.
new text end

new text begin (d) A licensed oral health practitioner may perform the following services under
the indirect supervision, unless restricted or prohibited in the collaborative management
agreement:
new text end

new text begin (1) placement of space maintainers; and
new text end

new text begin (2) fabrication of soft-occlusal guards.
new text end

new text begin (e) For purposes of this section, "general supervision" and "indirect supervision"
have the meanings given in Minnesota Rules, part 3100.0100, subpart 21.
new text end

new text begin Subd. 5. new text end

new text begin Prescribing authority. new text end

new text begin (a) A licensed oral health practitioner may
prescribe, dispense, and administer the following drugs within the parameters of the
collaborative management agreement and within the scope of practice of the oral health
practitioner: analgesics, anti-inflammatories, and antibiotics.
new text end

new text begin (b) The authority to prescribe, dispense, and administer shall extend only to the
categories of drugs identified in this subdivision, and may be further limited by the
collaborative management agreement.
new text end

new text begin (c) The authority to dispense includes the authority to dispense sample drugs within
the categories identified in this subdivision if dispensing is permitted by the collaborative
management agreement.
new text end

new text begin (d) Notwithstanding paragraph (a), a licensed oral health practitioner is prohibited
from dispensing, prescribing, or administering a narcotic drug as defined in section
152.01, subdivision 10.
new text end

new text begin Subd. 6. new text end

new text begin Application of other laws. new text end

new text begin A licensed oral health practitioner authorized
to practice under this chapter is not in violation of section 150A.05 as it relates to the
unauthorized practice of dentistry if the practice is authorized under this chapter and is
within the parameters of the collaborative management agreement.
new text end

new text begin Subd. 7. new text end

new text begin Use of dental allied personnel. new text end

new text begin (a) A licensed oral health practitioner
may supervise registered and unregistered dental assistants to the extent permitted in the
collaborative management agreement and according to section 150A.10.
new text end

new text begin (b) Notwithstanding paragraph (a), a licensed oral health practitioner is limited to
supervising no more than four registered dental assistants at any one practice setting.
new text end

new text begin Subd. 8. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the following definitions
apply.
new text end

new text begin (b) "Practice settings that serve the low-income, uninsured, and underserved" mean:
new text end

new text begin (1) critical access dental provider settings as designated by the commissioner of
human services under section 256B.76, paragraph (c);
new text end

new text begin (2) dental hygiene collaborative practice settings identified in section 150A.10,
subdivision 1a, paragraph (e), medical facilities, assisted living facilities, local and state
correctional facilities, federally qualified health centers, and organizations eligible to
receive a community clinic grant under section 145.9268, subdivision 1;
new text end

new text begin (3) military and veterans administration hospitals, clinics, and care settings;
new text end

new text begin (4) a patient's residence or home when the patient is homebound or receiving or
eligible to receive home care services or home and community-based waivered services,
regardless of the patient's income;
new text end

new text begin (5) oral health educational institutions; or
new text end

new text begin (6) any other clinic or practice setting, including mobile dental units, in which at
least 50 percent of the oral health practitioner's total patient base in that clinic or practice
setting are patients who:
new text end

new text begin (i) are enrolled in a Minnesota health care program;
new text end

new text begin (ii) have a medical disability or chronic condition that creates a significant barrier
to receiving dental care;
new text end

new text begin (iii) reside in geographically isolated or medically underserved areas; or
new text end

new text begin (iv) do not have dental health coverage either through a Minnesota health care
program or private insurance.
new text end

new text begin (c) "Dental health professional shortage area" means an area that meets the criteria
established by the secretary of the United States Department of Health and Human
Services and is designated as such under United States Code, title 42, section 254e.
new text end

Sec. 23.

Minnesota Statutes 2008, section 150A.11, subdivision 4, is amended to read:

Subd. 4.

Dividing fees.

It shall be unlawful for any dentist to divide fees with or
promise to pay a part of the dentist's fee to, or to pay a commission to, any dentist or
other person who calls the dentist in consultation or who sends patients to the dentist for
treatment, or operation, but nothing herein shall prevent licensed dentists from forming
a bona fide partnership for the practice of dentistry, nor to the actual employment by
a licensed dentist of new text begin , a licensed oral health practitioner, new text end a licensed dental hygienist or
another licensed dentist.

Sec. 24.

Minnesota Statutes 2008, section 150A.12, is amended to read:

150A.12 VIOLATION AND DEFENSES.

Every person who violates any of the provisions of sections 150A.01 to 150A.12
for which no specific penalty is provided herein, shall be guilty of a gross misdemeanor;
and, upon conviction, punished by a fine of not more than $3,000 or by imprisonment in
the county jail for not more than one year or by both such fine and imprisonment. In
the prosecution of any person for violation of sections 150A.01 to 150A.12, it shall not
be necessary to allege or prove lack of a valid license to practice dentistry deleted text begin or deleted text end new text begin , new text end dental
hygiene new text begin , or as an oral health practitioner new text end but deleted text begin such matter deleted text end shall be a matter of defense to
be established by the defendant.

Sec. 25.

Minnesota Statutes 2008, section 150A.21, subdivision 1, is amended to read:

Subdivision 1.

Patient's name and Social Security number.

Every complete
upper and lower denture and removable dental prosthesis fabricated by a dentist licensed
under section 150A.06, or fabricated pursuant to the dentist's new text begin or oral health practitioner's
new text end work order, shall be marked with the name and Social Security number of the patient for
whom the prosthesis is intended. The markings shall be done during fabrication and shall
be permanent, legible and cosmetically acceptable. The exact location of the markings
and the methods used to apply or implant them shall be determined by the dentist new text begin , oral
health practitioner, new text end or dental laboratory fabricating the prosthesis. If in the professional
judgment of the dentist new text begin , oral health practitioner, new text end or dental laboratory, this identification is
not practicable, identification shall be provided as follows:

(a) The Social Security number of the patient may be omitted if the name of the
patient is shown;

(b) The initials of the patient may be shown alone, if use of the name of the patient is
impracticable;

(c) The identification marks may be omitted in their entirety if none of the forms of
identification specified in clauses (a) and (b) are practicable or clinically safe.

Sec. 26.

Minnesota Statutes 2008, section 150A.21, subdivision 4, is amended to read:

Subd. 4.

Failure to comply.

Failure of any dentist new text begin or oral health practitioner new text end to
comply with this section shall be deemed to be a violation for which the dentist new text begin or oral
health practitioner new text end may be subject to proceedings pursuant to section 150A.08, provided
the dentist new text begin or oral health practitioner new text end is charged with the violation within two years of
initial insertion of the dental prosthetic device.

Sec. 27.

Minnesota Statutes 2008, section 151.01, subdivision 23, is amended to read:

Subd. 23.

Practitioner.

"Practitioner" means a licensed doctor of medicine, licensed
doctor of osteopathy duly licensed to practice medicine, licensed doctor of dentistry,
licensed doctor of optometry, licensed podiatrist, or licensed veterinarian. For purposes
of sections 151.15, subdivision 4, 151.37, subdivision 2, paragraphs (b), (e), and (f), and
151.461, "practitioner" also means a physician assistant authorized to prescribe, dispense,
and administer under chapter 147A, deleted text begin or deleted text end an advanced practice nurse authorized to prescribe,
dispense, and administer under section 148.235 new text begin , or a licensed oral health practitioner
authorized to prescribe, dispense, and administer under chapter 150A new text end .

Sec. 28.

Minnesota Statutes 2008, section 151.37, subdivision 2, is amended to read:

Subd. 2.

Prescribing and filing.

(a) A licensed practitioner in the course of
professional practice only, may prescribe, administer, and dispense a legend drug,
and may cause the same to be administered by a nurse, a physician assistant, new text begin an oral
health practitioner, new text end or medical student or resident under the practitioner's direction and
supervision, and may cause a person who is an appropriately certified, registered, or
licensed health care professional to prescribe, dispense, and administer the same within
the expressed legal scope of the person's practice as defined in Minnesota Statutes. A
licensed practitioner may prescribe a legend drug, without reference to a specific patient,
by directing a nurse, pursuant to section 148.235, subdivisions 8 and 9, new text begin an oral health
practitioner under chapter 150A, a new text end physician assistant, or new text begin a new text end medical student or resident to
adhere to a particular practice guideline or protocol when treating patients whose condition
falls within such guideline or protocol, and when such guideline or protocol specifies the
circumstances under which the legend drug is to be prescribed and administered. An
individual who verbally, electronically, or otherwise transmits a written, oral, or electronic
order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug.
This paragraph applies to a physician assistant only if the physician assistant meets the
requirements of section 147A.18.

(b) A licensed practitioner that dispenses for profit a legend drug that is to be
administered orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must
file with the practitioner's licensing board a statement indicating that the practitioner
dispenses legend drugs for profit, the general circumstances under which the practitioner
dispenses for profit, and the types of legend drugs generally dispensed. It is unlawful to
dispense legend drugs for profit after July 31, 1990, unless the statement has been filed
with the appropriate licensing board. For purposes of this paragraph, "profit" means (1)
any amount received by the practitioner in excess of the acquisition cost of a legend drug
for legend drugs that are purchased in prepackaged form, or (2) any amount received
by the practitioner in excess of the acquisition cost of a legend drug plus the cost of
making the drug available if the legend drug requires compounding, packaging, or other
treatment. The statement filed under this paragraph is public data under section 13.03.
This paragraph does not apply to a licensed doctor of veterinary medicine or a registered
pharmacist. Any person other than a licensed practitioner with the authority to prescribe,
dispense, and administer a legend drug under paragraph (a) shall not dispense for profit.
To dispense for profit does not include dispensing by a community health clinic when the
profit from dispensing is used to meet operating expenses.

(c) A prescription or drug order for the following drugs is not valid, unless it can be
established that the prescription or order was based on a documented patient evaluation,
including an examination, adequate to establish a diagnosis and identify underlying
conditions and contraindications to treatment:

(1) controlled substance drugs listed in section 152.02, subdivisions 3 to 5;

(2) drugs defined by the Board of Pharmacy as controlled substances under section
152.02, subdivisions 7, 8, and 12;

(3) muscle relaxants;

(4) centrally acting analgesics with opioid activity;

(5) drugs containing butalbital; or

(6) phoshodiesterase type 5 inhibitors when used to treat erectile dysfunction.

(d) For the purposes of paragraph (c), the requirement for an examination shall be
met if an in-person examination has been completed in any of the following circumstances:

(1) the prescribing practitioner examines the patient at the time the prescription
or drug order is issued;

(2) the prescribing practitioner has performed a prior examination of the patient;

(3) another prescribing practitioner practicing within the same group or clinic as the
prescribing practitioner has examined the patient;

(4) a consulting practitioner to whom the prescribing practitioner has referred the
patient has examined the patient; or

(5) the referring practitioner has performed an examination in the case of a
consultant practitioner issuing a prescription or drug order when providing services by
means of telemedicine.

(e) Nothing in paragraph (c) or (d) prohibits a licensed practitioner from prescribing
a drug through the use of a guideline or protocol pursuant to paragraph (a).

(f) Nothing in this chapter prohibits a licensed practitioner from issuing a
prescription or dispensing a legend drug in accordance with the Expedited Partner Therapy
in the Management of Sexually Transmitted Diseases guidance document issued by the
United States Centers for Disease Control.

(g) Nothing in paragraph (c) or (d) limits prescription, administration, or dispensing
of legend drugs through a public health clinic or other distribution mechanism approved
by the commissioner of health or a board of health in order to prevent, mitigate, or treat
a pandemic illness, infectious disease outbreak, or intentional or accidental release of a
biological, chemical, or radiological agent.

(h) No pharmacist employed by, under contract to, or working for a pharmacy
licensed under section 151.19, subdivision 1, may dispense a legend drug based on a
prescription that the pharmacist knows, or would reasonably be expected to know, is not
valid under paragraph (c).

(i) No pharmacist employed by, under contract to, or working for a pharmacy
licensed under section 151.19, subdivision 2, may dispense a legend drug to a resident
of this state based on a prescription that the pharmacist knows, or would reasonably be
expected to know, is not valid under paragraph (c).

Sec. 29. new text begin IMPACT OF ORAL HEALTH PRACTITIONERS.
new text end

new text begin (a) The Board of Dentistry shall evaluate the impact of the use of oral health
practitioners on the delivery of and access to dental services. The board shall report to the
chairs and ranking minority members of the legislative committees with jurisdiction over
health care by January 15, 2014:
new text end

new text begin (1) the number of oral health practitioners annually licensed by the board beginning
in 2011;
new text end

new text begin (2) the settings where licensed oral health practitioners are practicing and the
populations being served;
new text end

new text begin (3) the number of complaints filed against oral health practitioners and the basis
for each complaint; and
new text end

new text begin (4) the number of disciplinary actions taken against oral health practitioners.
new text end

new text begin (b) The board, in consultation with the Department of Human Services, shall also
include the number and type of dental services that were performed by oral health
practitioners and reimbursed by the state under the Minnesota state health care programs
for the 2013 fiscal year.
new text end

new text begin (c) The Board of Dentistry, in consultation with the Department of Health, shall
develop an evaluation process that focuses on assessing the impact of oral health
practitioners in terms of patient safety, cost effectiveness, and access to dental services.
The process shall focus on the following outcome measures:
new text end

new text begin (1) number of new patients served;
new text end

new text begin (2) reduction in waiting times for needed services;
new text end

new text begin (3) decreased travel time for patients;
new text end

new text begin (4) impact on emergency room usage for dental care; and
new text end

new text begin (5) costs to the public health care system.
new text end

Sec. 30. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2008, section 150A.061, new text end new text begin is repealed.
new text end