Minnesota Legislature
Office of the Revisor of Statutes
Minnesota Session Laws - 2003, 1st Special Session
Key: (1) language to be deleted (2) new language
CHAPTER 5-S.F.No. 13
An act relating to health; modifying dental practice
provisions; requiring a study; amending Minnesota
Statutes 2002, sections 150A.06, subdivisions 1a, 3,
by adding a subdivision; 150A.10, subdivision 1a, by
adding a subdivision; 256B.55, subdivisions 3, 4, 5.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. Minnesota Statutes 2002, section 150A.06,
subdivision 1a, is amended to read:
Subd. 1a. [FACULTY DENTISTS.] (a) Faculty members of a
school of dentistry must be licensed or registered in order to
practice dentistry as defined in section 150A.05. The board may
issue to members of the faculty of a school of dentistry a
license designated as either a "limited faculty license" or a
"full faculty license" entitling the holder to practice
dentistry within the school and its affiliated teaching
facilities, but only for the purposes of instructing or
conducting research. The practice of dentistry at a school
facility for purposes other than instruction or research is not
allowed unless the faculty member is licensed under subdivision
1 or is a faculty member on August 1, 1993 terms described in
paragraph (b) or (c). The dean of the school of dentistry and
program directors of accredited Minnesota dental hygiene or
dental assisting schools shall certify to the board those
members of the school's faculty who practice dentistry but are
not licensed to practice dentistry in Minnesota. A faculty
member who practices dentistry as defined in section 150A.05,
before beginning duties in the school of dentistry, shall apply
to the board for a limited or full faculty license. The license
expires the next July 1 and may, at the discretion of the board,
be renewed on a yearly basis. The faculty applicant shall pay a
nonrefundable fee set by the board for issuing and renewing the
faculty license. The faculty license is valid during the time
the holder remains a member of the faculty of a school of
dentistry and subjects the holder to this chapter. This
subdivision takes effect on September 1 following the date that
the rules adopted under this subdivision become effective.
(b) The board may issue to dentist members of the faculty
of an accredited Minnesota school of dentistry, dental hygiene,
or dental assisting a license designated as a limited faculty
license entitling the holder to practice dentistry within the
school and its affiliated teaching facilities, but only for the
purposes of instructing or conducting research. The practice of
dentistry at a school facility for purposes other than
instruction or research is not allowed unless the faculty member
is licensed under subdivision 1 or is a faculty member on August
1, 1993.
(c) The board may issue to dentist members of the faculty
of an accredited Minnesota school of dentistry, dental hygiene,
or dental assisting a license designated as a full faculty
license entitling the holder to practice dentistry within the
school and its affiliated teaching facilities and elsewhere if
the holder of the license is employed 50 percent time or more by
the school in the practice of teaching or research, and upon
successful review by the board of the applicant's qualifications
as described in subdivisions 1c and 4. The board, at its
discretion, may waive specific licensing prerequisites.
Sec. 2. Minnesota Statutes 2002, section 150A.06, is
amended by adding a subdivision to read:
Subd. 2d. [VOLUNTEER AND RETIRED DENTISTS, DENTAL
HYGIENISTS, AND REGISTERED DENTAL ASSISTANTS.] (a) The board
shall grant a waiver to the continuing education requirements
under this chapter for a dentist, dental hygienist, or
registered dental assistant who documents to the satisfaction of
the board that the dentist, 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, dental hygienist, or registered
dental assistant prior to granting this waiver.
(c) The board shall require the volunteer and retired
dentist, dental hygienist, or registered dental assistant to
meet the following requirements:
(1) a licensee or registrant seeking a waiver under this
subdivision must complete 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. 3. Minnesota Statutes 2002, section 150A.06,
subdivision 3, is amended to read:
Subd. 3. [WAIVER OF EXAMINATION.] (a) All or any part of
the examination for dentists or dental hygienists, except that
pertaining to the law of Minnesota relating to dentistry and the
rules of the board, may, at the discretion of the board, be
waived for an applicant who presents a certificate of
qualification from the national board of dental examiners or
evidence of having maintained an adequate scholastic standing as
determined by the board, in dental school as to dentists, or
dental hygiene school as to dental hygienists.
(b) Effective January 1, 2004, the board shall waive the
clinical examination required for licensure for any applicant
who is a graduate of a dental school accredited by the
commission on dental accreditation of the American Dental
Association or an equivalent organization as determined by the
board, who has successfully completed Parts I and II of National
Boards, and who has satisfactorily completed a Minnesota-based
postdoctoral general dentistry residency program accredited by
the commission on dental accreditation of the American Dental
Association if the program is of at least one year's duration
and includes an outcome assessment evaluation assessing the
resident's competence to practice dentistry. The board may
require the applicant to submit any information deemed necessary
by the board to determine whether the waiver is applicable. The
board may waive the clinical examination for an applicant who
meets the requirements of this paragraph and has satisfactorily
completed an accredited postdoctoral general dentistry residency
program located outside of Minnesota.
Sec. 4. Minnesota Statutes 2002, section 150A.10,
subdivision 1a, is amended to read:
Subd. 1a. [LIMITED AUTHORIZATION FOR DENTAL HYGIENISTS.]
(a) Notwithstanding subdivision 1, a dental hygienist licensed
under this chapter may be employed or retained by a health care
facility, program, or nonprofit organization to perform dental
hygiene services described under paragraph (b) without the
patient first being examined by a licensed dentist if the dental
hygienist:
(1) has two years practical clinical experience with a
licensed dentist within the preceding five years has been
engaged in the active practice of clinical dental hygiene for
not less than 2,400 hours in the past 18 months or a career
total of 3,000 hours, including a minimum of 200 hours of
clinical practice in two of the past three years; and
(2) has entered into a collaborative agreement with a
licensed dentist that designates authorization for the services
provided by the dental hygienist;
(3) has documented participation in courses in infection
control and medical emergencies within each continuing education
cycle; and
(4) maintains current certification in advanced or basic
cardiac life support as recognized by the American Heart
Association, the American Red Cross, or another agency that is
equivalent to the American Heart Association or the American Red
Cross.
(b) The dental hygiene services authorized to be performed
by a dental hygienist under this subdivision are limited to:
(1) oral health promotion and disease prevention education;
(2) removal of deposits and stains from the surfaces of the
teeth,;
(3) application of topical preventive or prophylactic
agents, including fluoride varnishes and pit and fissure
sealants;
(4) polishing and smoothing restorations,;
(5) removal of marginal overhangs,;
(6) performance of preliminary charting,;
(7) taking of radiographs,; and
(8) performance of scaling and root planing and soft-tissue
curettage. The dental hygienist shall not place pit and fissure
sealants, unless the patient has been recently examined and the
treatment planned by a licensed dentist.
The dental hygienist shall not perform injections of anesthetic
agents or the administration of nitrous oxide unless under the
indirect supervision of a licensed dentist. Collaborating
dental hygienists may work with unregistered and registered
dental assistants who may only perform duties for which
registration is not required. The performance of dental hygiene
services in a health care facility, program, or nonprofit
organization as authorized under this subdivision is limited to
patients, students, and residents of the facility, program, or
organization.
(c) A collaborating dentist must be licensed under this
chapter and may enter into a collaborative agreement with no
more than four dental hygienists unless otherwise authorized by
the board. The board shall develop parameters and a process for
obtaining authorization to collaborate with more than four
dental hygienists. The collaborative agreement must include:
(1) consideration for medically compromised patients and
medical conditions for which a dental evaluation and treatment
plan must occur prior to the provision of dental hygiene
services; and
(2) age- and procedure-specific standard collaborative
practice protocols, including recommended intervals for the
performance of dental hygiene services and a period of time in
which an examination by a dentist should occur;
(3) copies of consent to treatment form provided to the
patient by the dental hygienist;
(4) specific protocols for the placement of pit and fissure
sealants and requirements for follow-up care to assure the
efficacy of the sealants after application; and
(5) a procedure for creating and maintaining dental records
for the patients that are treated by the dental hygienist. This
procedure must specify where these records are to be located.
The collaborative agreement must be signed and maintained by the
dentist and, the dental hygienist, and the facility, program, or
organization; must be reviewed annually by the collaborating
dentist and dental hygienist; and must be made available to the
board upon request.
(d) Before performing any services authorized under this
subdivision, a dental hygienist must provide the patient with a
consent to treatment form which must include a statement
advising the patient that the dental hygiene services provided
are not a substitute for a dental examination by a licensed
dentist. If the dental hygienist makes any referrals to the
patient for further dental procedures, the dental hygienist must
fill out a referral form and provide a copy of the form to the
collaborating dentist.
(e) For the purposes of this subdivision, a "health care
facility, program, or nonprofit organization" is limited to a
hospital; nursing home; home health agency; group home serving
the elderly, disabled, or juveniles; state-operated facility
licensed by the commissioner of human services or the
commissioner of corrections; and federal, state, or local public
health facility, community clinic, or tribal clinic, school
authority, Head Start program, or nonprofit organization that
serves individuals who are uninsured or who are Minnesota health
care public program recipients.
(e) (f) For purposes of this subdivision, a "collaborative
agreement" means a written agreement with a licensed dentist who
authorizes and accepts responsibility for the services performed
by the dental hygienist. The services authorized under this
subdivision and the collaborative agreement may be performed
without the presence of a licensed dentist and may be performed
at a location other than the usual place of practice of the
dentist or dental hygienist and without a dentist's diagnosis
and treatment plan, unless specified in the collaborative
agreement.
Sec. 5. Minnesota Statutes 2002, section 150A.10, is
amended by adding a subdivision 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 has authorized the procedure to be
performed; and
(4) a licensed dentist 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. 6. Minnesota Statutes 2002, section 256B.55,
subdivision 3, is amended to read:
Subd. 3. [DUTIES.] The advisory committee shall provide
recommendations on the following:
(1) how to reduce the administrative burden governing
dental care coverage policies in order to promote administrative
simplification, including prior authorization, coverage limits,
and co-payment collections developing a new model for
purchasing, administering, and delivering dental care services
to public program recipients based on public health principles;
(2) developing and implementing an action plan to improve
the oral health of children and persons with special needs in
the state exploring innovative ways to develop workforce
solutions to ensure access to dental care statewide; and
(3) exploring alternative ways of purchasing and improving
access to dental services;
(4) developing ways to foster greater responsibility among
health care program recipients in seeking and obtaining dental
care, including initiatives to keep dental appointments and
comply with dental care plans;
(5) exploring innovative ways for dental providers to
schedule public program patients in order to reduce or minimize
the effect of appointment no shows;
(6) exploring ways to meet the barriers that may be present
in providing dental services to health care program recipients
such as language, culture, disability, and lack of
transportation; and
(7) exploring the possibility of pediatricians, family
physicians, and nurse practitioners providing basic oral health
screenings and basic preventive dental services identifying data
needed to effectively evaluate the dental care needs of the
state.
Sec. 7. Minnesota Statutes 2002, section 256B.55,
subdivision 4, is amended to read:
Subd. 4. [REPORT.] The commissioner shall submit a report
by February 1, 2002, and by each February 1, 2003 thereafter,
summarizing the activities and recommendations of the advisory
committee.
Sec. 8. Minnesota Statutes 2002, section 256B.55,
subdivision 5, is amended to read:
Subd. 5. [SUNSET.] Notwithstanding section 15.059,
subdivision 5, this section expires June 30, 2003 2007.
Sec. 9. [URGENT CARE DENTAL CLINIC.]
The commissioner of human services, in consultation with
the dental access advisory committee, is requested to report on
the feasibility of developing one or more urgent care dental
clinics. The primary purpose of an urgent care dental clinic is
to provide recipients of medical assistance, general assistance
medical care, and MinnesotaCare with an alternative to receiving
dental care services in hospital emergency rooms. The
commissioner shall determine if savings from the reduction in
dental care provided in emergency rooms would warrant the
construction of urgent care facilities. The commissioner may
seek funding for the construction and operation of a dental
urgent care clinic from the federal government as authorized by
Congress under the dental health improvement provisions of the
Health Care Safety Net Improvement Act of 2002.
Sec. 10. [DENTAL ASSISTANT STUDY.]
The board of dentistry, in consultation with the Minnesota
Dental Association, the Minnesota Dental Assistants Association,
and the Minnesota Dental Hygienists' Association, shall make
recommendations on the appropriate level of regulation for
dental assistants and the appropriate terminology used to
distinguish the different levels of training and education. The
recommendations must include:
(1) whether registered dental assistants should be
licensed; and
(2) whether the term "nonregistered dental assistants"
should be changed to a term that better describes this position.
In making these recommendations, the board must consult
with representatives of registered and nonregistered dental
assistants and must review the issues in terms of the
requirements of Minnesota Statutes, section 214.001, subdivision
2, and consumer safety and awareness. The board must report the
recommendations to the chairs and ranking minority members of
the house and senate health and human services policy committees
by January 15, 2004.
Sec. 11. [EXPIRATION.]
Minnesota Statutes 2002, section 150A.06, subdivision 3,
paragraph (b), expires on August 1, 2008.
Presented to the governor May 27, 2003
Signed by the governor May 30, 2003, 4:03 p.m.
Official Publication of the State of Minnesota
Revisor of Statutes