HP0657, LD 933, item 1, An Act To Establish a Separate Regulatory Board for Dental Hygienists

An Act To Establish a Separate Regulatory Board for Dental Hygienists

Be it enacted by the People of the State of Maine as follows:

Sec. 1. 5 MRSA §12004-A, sub-§10-A is enacted to read:

10-A.

State Board of Dental Hygienists

Legislative Per Diem

32 MRSA §19121

Sec. 2. 13 MRSA §732, sub-§4, as amended by PL 2007, c. 620, Pt. D, §1, is further amended to read:

4. Dentists, denturists, independent practice dental hygienists and any related licensed dental hygiene professionals. For the purposes of this chapter, a denturist or licensed under Title 32, chapter 16, an independent practice dental hygienist licensed under Title 32, chapter 16 141 or any related licensed dental hygiene professional may organize with a dentist who is licensed under Title 32, chapter 16 and may become a shareholder of a dental practice incorporated under the corporation laws. At no time may one or more denturists or , independent practice dental hygienists or any related licensed dental hygiene professionals in sum have an equal or greater ownership interest in a dental practice than the dentist or dentists have in that practice.

Sec. 3. 22 MRSA §3174-RR, sub-§1, as reallocated by RR 2011, c. 1, §32, is amended to read:

1. Reimbursement. By October 1, 2012, the department shall provide for the reimbursement under the MaineCare program of independent practice dental hygienists practicing as authorized under Title 32, section 1094-I 19161 for the following procedures:

A. Prophylaxis performed on a person who is 21 years of age or younger;

B. Topical application of fluoride performed on a person who is 21 years of age or younger;

C. Provision of oral hygiene instructions;

D. The application of sealants;

E. Temporary fillings; and

F. X-rays. Radiographic procedures, including but not limited to:

(1) Periapical x-rays;

(2) Bite-wing x-rays;

(3) Panoramic x-rays; and

(4) Full-mouth services.

Reimbursement must be provided to independent practice dental hygienists directly or to a federally qualified health center pursuant to section 3174-V when an independent practice dental hygienist is employed as a core provider at the center.

Sec. 4. 24-A MRSA §2765, sub-§1, as enacted by PL 2009, c. 307, §2 and affected by §6, is amended to read:

1. Services provided by independent practice dental hygienist. An insurer that issues individual dental insurance or health insurance that includes coverage for dental services shall provide coverage for dental services performed by an independent practice dental hygienist licensed under Title 32, chapter 16 141, subchapter 3-B 4 when those services are covered services under the contract and when they are within the lawful scope of practice of the independent practice dental hygienist.

Sec. 5. 24-A MRSA §2847-Q, sub-§1, as enacted by PL 2009, c. 307, §3 and affected by §6, is amended to read:

1. Services provided by independent practice dental hygienist. An insurer that issues group dental insurance or health insurance that includes coverage for dental services shall provide coverage for dental services performed by an independent practice dental hygienist licensed under Title 32, chapter 16 141, subchapter 3-B 4 when those services are covered services under the contract and when they are within the lawful scope of practice of the independent practice dental hygienist.

Sec. 6. 24-A MRSA §4257, sub-§1, as enacted by PL 2009, c. 307, §4 and affected by §6, is amended to read:

1. Services provided by independent practice dental hygienist. All individual and group health maintenance organization contracts that include coverage for dental services shall provide coverage for dental services performed by an independent practice dental hygienist licensed under Title 32, chapter 16 141, subchapter 3-B 4 when those services are covered services under the contract and when they are within the lawful scope of practice of the independent practice dental hygienist.

Sec. 7. 32 MRSA §1062-A, sub-§1, as amended by PL 2011, c. 184, §1, is further amended to read:

1. Penalties. A person who practices or falsely claims legal authority to practice dentistry, dental hygiene, independent practice dental hygiene, denturism or dental radiography in this State without first obtaining a license as required by this chapter, or after the license has expired, has been suspended or revoked or has been temporarily suspended or revoked, commits a Class E crime. Violation of this subsection is a strict liability crime as defined in Title 17-A, section 34, subsection 4-A.

Sec. 8. 32 MRSA §1071, first ¶, as amended by PL 2003, c. 669, §1, is further amended to read:

The Board of Dental Examiners, established by Title 5, section 12004-A, subsection 10, and in this chapter called the "board," consists of 9 7 members, appointed by the Governor as follows: five 5 members of the dental profession, 2 dental hygienists, one denturist and one representative of the public.

Sec. 9. 32 MRSA §1071, sub-§2, as amended by PL 1993, c. 600, Pt. A, §56, is further amended to read:

2. Dentists. The Governor may accept nominations from the Maine Dental Association and from other organizations and individuals.

Members of the dental profession must hold a valid dental license and must have been in the actual practice of dentistry in this State for at least 10 years immediately preceding the appointment. The term for a member who is a dentist is 5 years. A dentist is not eligible to serve as a member of the board while employing a dental hygienist who is a member of the board.

Sec. 10. 32 MRSA §1071, sub-§3, as amended by PL 2003, c. 669, §2, is repealed.

Sec. 11. 32 MRSA §1079, as amended by PL 2007, c. 620, Pt. A, §2, is repealed.

Sec. 12. 32 MRSA §1080, sub-§2, as enacted by PL 2011, c. 581, §2, is amended to read:

2. Establishment of a pool of panel members. The board shall establish a pool of potential panel members. The board may not select a person for the pool who has been found in violation of the dental practices laws or rules within the preceding 10 years. After selection by the board, each member of the pool is subject to review and appointment by the Governor. The pool must be composed of at least 5 dentists , and 5 denturists and 5 dental hygienists licensed under this chapter and 5 public members, but if the board finds that it is beneficial to the administration of the pool, the pool may be composed of no fewer than 3 from each category. A pool member may not be a member of the board.

Sec. 13. 32 MRSA §1080, sub-§4, ¶B, as enacted by PL 2011, c. 581, §2, is amended to read:

B. One member must be either a denturist or a dental hygienist. A dental hygienist must be named to the first panel convened. For subsequent panels, the seat must alternate between a dental hygienist and a denturist, unless the defendant is either a denturist or a dental hygienist, in which case the member filling this seat must be of the defendant's profession; and

Sec. 14. 32 MRSA §1081, sub-§2, ¶H, as enacted by PL 2007, c. 620, Pt. C, §4, is amended to read:

H. Practice by an independent practice dental hygienist pursuant to chapter 141, subchapter 3-B 4.

Sec. 15. 32 MRSA §1081, sub-§3, as amended by PL 2007, c. 620, Pt. C, §5, is further amended to read:

3. Proprietor. The term proprietor, as used in this chapter, includes a person who:

A. Employs dentists or dental hygienists, independent practice dental hygienists, denturists or other dental auxiliaries in the operation of a dental office;

B. Places in possession of a dentist or a dental hygienist, independent practice dental hygienist or other dental auxiliary or other agent dental material or equipment that may be necessary for the management of a dental office on the basis of a lease or any other agreement for compensation for the use of that material, equipment or office; or

C. Retains the ownership or control of dental equipment or material or a dental office and makes the same available in any manner for the use by dentists or dental hygienists, independent practice dental hygienists or other agents, except that nothing in this subsection applies to bona fide sales of dental equipment or material secured by a chattel mortgage or retain title agreement. A person licensed to practice dentistry may not enter into arrangements with a person who is not licensed to practice dentistry, with the exception of licensed denturists and independent practice dental hygienists, or the legal guardian or personal representative of a deceased or incapacitated dentist, pursuant to the provisions of Title 13, section 732.

Sec. 16. 32 MRSA §1081, sub-§6, as enacted by PL 2007, c. 620, Pt. C, §6, is amended to read:

6. Dental hygienist. "Dental hygienist" or "independent practice dental hygienist," as used in this chapter, means a dental auxiliary licensed pursuant to chapter 141, subchapter 3-B 3 or 4 who delivers preventive and educational services for the control of oral disease and the promotion of oral health within the scope of practice authorized by the person's license.

Sec. 17. 32 MRSA c. 16, sub-cc. 3-B and 4, as amended, are repealed.

Sec. 18. 32 MRSA §1100-A, as amended by PL 2007, c. 620, Pt. C, §10, is further amended to read:

§ 1100-A. Definition

Duties of dental auxiliaries other than dental hygienists and expanded function dental assistants must be defined and governed by the rules of the Board of Dental Examiners, except that duties of independent practice dental hygienists set forth in section 1094-Q 19169, subsection 1 may not be restricted or expanded by the board. Dental auxiliaries include, but are not limited to, dental hygienists, independent practice dental hygienists, dental assistants, expanded function dental assistants, dental laboratory technicians and denturists.

Sec. 19. 32 MRSA §1100-J, sub-§3, ¶A, as enacted by PL 1983, c. 331, §2, is amended to read:

A. Dental hygienists licensed pursuant to chapter 141, subchapter IV 3;

Sec. 20. 32 MRSA §9854, sub-§3, ¶A, as enacted by PL 1983, c. 524, is amended to read:

A. A dental hygienist licensed under chapter 16 141, subchapter IV 3;

Sec. 21. 32 MRSA c. 141 is enacted to read:

CHAPTER 141

DENTAL HYGIENISTS

SUBCHAPTER 1

GENERAL PROVISIONS

§ 19101. Definitions

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings.

1. Board. "Board" means the State Board of Dental Hygienists under section 19121.

2. Dental hygienist. "Dental hygienist" or "independent practice dental hygienist" means a dental auxiliary, as described under section 1100-A, licensed pursuant to subchapter 3 or 4, respectively, who delivers preventive and educational services for the control of oral disease and the promotion of oral health within the scope of practice authorized by the person's license.

§ 19102. Addresses and change of address

1. Furnish to board. A licensee under this chapter shall:

A. Furnish the secretary of the board with the licensee's place or places of practice; and

B. Upon a change of name or registered address or addresses, furnish the secretary of the board with the new name or address within 30 days of the change.

2. Failure; fee. For failure to comply with this section, a licensee is subject to a fee imposed by the board of not more than $25.

§ 19103. Penalties; injunction

1. Penalties. A person who practices or falsely claims legal authority to practice dental hygiene or independent practice dental hygiene in this State without first obtaining a license as required by this chapter, or after the license has expired, has been suspended or revoked or has been temporarily suspended or revoked, commits a Class E crime. Violation of this subsection is a strict liability crime as defined in Title 17-A, section 34, subsection 4-A.

2. Injunction. The State may bring an action in Superior Court to enjoin a person for violating this chapter, regardless of whether proceedings have been or may be instituted in the District Court or whether criminal proceedings have been or may be instituted.

SUBCHAPTER 2

STATE BOARD OF DENTAL HYGIENISTS

§ 19121. Appointment; term; removal

The State Board of Dental Hygienists, as established by Title 5, section 12004-A, subsection 10-A, consists of 5 members who are appointed by the Governor. A full-term appointment is for 5 years. Appointment of members must comply with Title 10, section 8009. Members of the board may be removed from office for cause by the Governor.

§ 19122. Qualifications

A member of the board must be a citizen of the United States and a resident of this State for at least 3 consecutive years prior to appointment and shall file with the Secretary of State an oath of office before beginning service. The board is composed of:

1. Registered dental hygienists. Two dental hygienists, each of whom:

A. Is a graduate of a state-approved educational program in dental hygiene; and

B. Holds a current state license to practice dental hygiene.

One dental hygienist must be active in an approved educational program in dental hygiene. One dental hygienist must be active in dental hygiene service;

2. Public health dental hygienist. One public health dental hygienist with public health supervision status as described in section 19149 who:

A. Is a graduate of a state-approved educational program in public health dental hygiene; and

B. Holds a current state license to practice public health dental hygiene;

3. Independent practice dental hygienist. One independent practice dental hygienist who:

A. Is a graduate of a state-approved educational program in independent practice dental hygiene; and

B. Holds a current state license as an independent practice dental hygienist; and

4. Public member. One public member. A person may not qualify for appointment as a public member of the board if that person or a member of that person's immediate family is:

A. A member of another state licensing board;

B. On the board of a health care agency; or

C. Engaged for compensation in the provision of health services or the provision of health research, instruction or insurance.

§ 19123. Powers and duties

The board shall hold annual meetings at which it shall elect from its members a chair and a secretary. It may hold such other meetings during the year as it determines necessary to transact its business. Special meetings must be called by the secretary on the request of 2 members. Three members of the board constitute a quorum at a meeting.

The board shall perform an initial review of all complaints initiated pursuant to section 19124 involving dental hygienists and independent practice dental hygienists. Upon completion of the board's review of a complaint, the secretary of the board shall dispose of the complaint in accordance with those dispositions authorized by section 19124.

The board shall perform an initial review of all applications for licensure as a dental hygienist pursuant to section 19143 and an independent practice dental hygienist pursuant to section 19165, all submissions relating to continuing education of a dental hygienist pursuant to section 19146 and an independent practice dental hygienist pursuant to section 19168 and all submissions relating to public health supervision status of a dental hygienist and an independent practice dental hygienist as defined by board rule. Upon completion of its review of an application or submission, the board shall dispose of the application or submission, including issuance, renewal, denial or nonrenewal of a dental hygienist and an independent practice dental hygienist license.

The board:

1. Bylaws. May adopt bylaws and rules for the transaction of the business of the board and the government and management of its affairs, not inconsistent with the laws of this State and of the United States, as it considers expedient;

2. Seal. May adopt a seal, which must be placed in the care of the executive director;

3. Curricula. May prescribe curricula and standards for educational programs preparing individuals for licensure under this chapter;

4. Surveys. May provide for surveys of the programs described in subsection 3 as it determines necessary;

5. Approval. May approve such dental hygiene educational programs within the State as meet the requirements of this chapter and of the board;

6. Denial. May place dental hygiene educational programs on probation or warn, or deny, condition, withdraw or discontinue approval of, dental hygiene educational programs for failure to meet approved curricula or other standards as established by this chapter or pursuant to law;

7. Licenses. May examine, license and renew the licenses of qualified applicants;

8. Prosecution. May cause the prosecution and enjoinder of individuals violating this chapter and incur necessary expenses for those activities;

9. Records. May keep a record of all its proceedings;

10. Report. May make an annual report to the Commissioner of Professional and Financial Regulation for each fiscal year showing its receipts and disbursements and giving a full account of its activities during the previous 12-month period;

11. Budget. Shall submit to the Commissioner of Professional and Financial Regulation its budgetary requirements in the same manner as is provided in Title 5, section 1665, and the commissioner shall in turn transmit these requirements to the Bureau of the Budget without any revision, alteration or change unless alterations are mutually agreed upon by the Department of Professional and Financial Regulation and the board or the board's designee. The budget submitted by the board to the commissioner must be sufficient to enable the board to comply with this chapter;

12. Executive and assistant director. May appoint and employ qualified individuals, not members of the board, to serve as executive director and assistant executive director to the board, fix their compensation and define their duties;

13. Other employees. May employ other individuals as may be necessary to carry out the work of the board;

14. Funds. May set aside and budget funds for, make contracts for and procure goods or services the board determines necessary to accomplish its duties under this chapter;

15. Accept federal funds. Notwithstanding section 19128, may accept for the State any federal funds appropriated under a federal law relating to the authorized programs of the board. The board may undertake the necessary duties and tasks to implement federal law with respect to the authorized programs of the board; and

16. Rulemaking. May establish rules to implement the provisions of this chapter. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.

§ 19124. Disciplinary actions

1. Disciplinary proceedings and sanctions. Regarding noncompliance with or violation of this chapter or of rules adopted by the board, the board shall investigate a complaint on its own motion or upon receipt of a written complaint filed with the board.

The board shall notify the licensee of the content of a complaint filed against the licensee as soon as possible, but no later than 60 days from receipt of this information. The licensee shall respond within 30 days. If the licensee's response to the complaint satisfies the board that the complaint does not merit further investigation or action, the matter may be dismissed, with notice of the dismissal to the complainant, if any.

If, in the opinion of the board, the factual basis of the complaint is or may be true and the complaint is of sufficient gravity to warrant further action, the board may request an informal conference with the licensee. The board shall provide the licensee with adequate notice of the conference and of the issues to be discussed. The conference must be conducted in executive session of the board, pursuant to Title 1, section 405, unless otherwise requested by the licensee. Statements made at the conference may not be introduced at a subsequent formal hearing unless all parties consent.

If the board finds that the factual basis of the complaint is true and is of sufficient gravity to warrant further action, it may take any of the following actions it considers appropriate:

A. With the consent of the licensee, enter into a consent agreement that takes any action authorized by Title 10, section 8003, subsection 5 or Title 10, section 8003-D. A consent agreement may be used to terminate a complaint investigation if entered into by the board, the licensee and the Attorney General's office;

B. In consideration for acceptance of a voluntary surrender of the license, if a consent agreement is signed by the board, the licensee and the Attorney General's office under paragraph A, negotiate stipulations, including terms and conditions for reinstatement, that ensure protection of the public health and safety and that serve to rehabilitate or educate the licensee;

C. If the board concludes that denial of initial licensure or modification or nonrenewal of an existing license is in order, refer the complaint to a dental hygienist adjudicatory panel, convened pursuant to section 19129, for the purpose of holding an adjudicatory hearing in accordance with the provisions of Title 5, chapter 375, subchapter 4; and

D. If the board concludes that suspension or revocation of the license is in order, file a complaint in the District Court in accordance with Title 4, chapter 5.

Notwithstanding Title 10, section 8003, subsection 5, any nonconsensual revocation of a license by a dental hygienist adjudicatory panel pursuant to Title 10, section 8003 may be imposed only after a hearing conforming to the requirements of Title 5, chapter 375, subchapter 4 and is subject to judicial review exclusively in the Superior Court in accordance with Title 5, chapter 375, subchapter 7. The board retains the authority to take any other action pursuant to this section and Title 10, section 8003 regarding the disposition of any complaint that does not involve an adjudicatory hearing.

2. Grounds for discipline. The board may suspend or revoke a license pursuant to Title 5, section 10004. The following are grounds for an action to refuse to issue, modify, suspend, revoke or refuse to renew the license of a person licensed under this chapter:

A. The practice of fraud or deceit in obtaining a license under this chapter or in connection with service rendered within the scope of the license issued;

B. Habitual substance abuse that has resulted or is foreseeably likely to result in the licensee's performing services in a manner that endangers the health or safety of patients;

C. A professional diagnosis of a mental or physical condition that has resulted or may result in the licensee's performing services in a manner that endangers the health or safety of patients;

D. Aiding or abetting the practice of a dental hygienist profession by an individual who is not licensed under this chapter and who claims to be legally licensed;

E. Incompetence in the practice for which the licensee is licensed. A licensee is considered incompetent in the practice if the licensee has:

(1) Engaged in conduct that evidences a lack of ability or fitness to perform the duties owed by the licensee to a client or patient or the general public; or

(2) Engaged in conduct that evidences a lack of knowledge or inability to apply principles or skills to carry out the practice for which the licensee is licensed;

F. Unprofessional conduct. A licensee is considered to have engaged in unprofessional conduct if the licensee violates a standard of professional behavior that has been established in the practice for which the licensee is licensed;

G. Subject to the limitations of Title 5, chapter 341, conviction of a crime that involves dishonesty or false statement or that relates directly to the practice for which the licensee is licensed or conviction of a crime for which incarceration for one year or more may be imposed;

H. A violation of this chapter or a rule adopted by the board; and

I. Engaging in false, misleading or deceptive advertising.

§ 19125. Liaison; limitations

The Commissioner of Professional and Financial Regulation shall act as a liaison between the board and the Governor. The commissioner may not exercise or interfere with the exercise of discretionary, regulatory or licensing authority granted by statute to the board. The commissioner may require the board to be accessible to the public for complaints and questions during regular business hours and to provide any information the commissioner requires in order to ensure that the board is operating administratively within the requirements of this chapter.

§ 19126. Qualifications of executive director

The executive director appointed pursuant to section 19123, subsection 12 must meet all the qualifications for dental hygienist board members required in section 19122.

§ 19127. Compensation

Eligible members of the board are entitled to compensation in accordance with the provisions of Title 5, chapter 379.

§ 19128. Disposition of funds

All money received by the board under this chapter must be paid to the Treasurer of State. The Treasurer of State shall place the money to the credit of the State Board of Dental Hygienists Fund, which is established as a nonlapsing, dedicated fund. All amounts paid into this fund must be held subject to the order of the board to be used only for the expenses incurred in the performance of the purposes of this chapter and the duties imposed by it as well as the promotion of dental hygiene education and standards of dental hygiene care in this State.

§ 19129. Dental hygienist adjudicatory panels

Dental hygienist adjudicatory panels may be convened in accordance with this section.

1. Purpose of panel. The purpose of a dental hygienist adjudicatory panel, referred to in this section as "a panel," is to conduct adjudicatory hearings independent of the board after the board conducts the initial investigation of a complaint against a licensee and refers the complaint to a panel.

2. Establishment of a pool of panel members. The board shall establish a pool of potential panel members. The board may not select a person for the pool who has been found in violation of the dental hygienist practices laws or rules within the preceding 10 years. After selection by the board, each member of the pool is subject to review and appointment by the Governor. The pool must be composed of at least 5 independent practice dental hygienists and 5 dental hygienists licensed under this chapter and 5 public members, but if the board finds that it is beneficial to the administration of the pool, the pool may be composed of no fewer than 3 from each category. A pool member may not be a member of the board.

3. Convening of a panel. The board may convene a panel for a case that cannot be resolved using a consent agreement. The board shall request a member of its staff to draw names from the pool in accordance with subsection 4. A member of the board may not have a role in the drawing or selection of individuals serving on a panel. For each case, a separate panel must be created and then dissolved once it has issued its decision.

4. Appointments for a panel. A panel consists of 4 members appointed from the pool under subsection 2:

A. One member must be a public member;

B. One member must be an independent practice dental hygienist;

C. One member must be a dental hygienist; and

D. One member must be either an independent practice dental hygienist or a dental hygienist. A dental hygienist must be named to the first panel convened. For subsequent panels, the seat must alternate between a dental hygienist and an independent practice dental hygienist, unless the defendant is either an independent practice dental hygienist or a dental hygienist, in which case the member filling this seat must be of the defendant's profession.

5. Vacancy. In the event of a vacancy on a panel, the board shall appoint a replacement member from the pool under subsection 2.

6. Terms; vacancy. Members of the pool under subsection 2 serve 5-year terms. Members may be reappointed. In the event of a vacancy in the pool, the board shall select a replacement member in the same manner as the original selection subject to the provisions of subsection 2.

7. Chair. The members of a panel shall select a chair from among its members. Any member may serve as the chair.

8. Duties and authority of a panel. Upon referral of a complaint by the board pursuant to section 19124, subsection 1, paragraph C to a panel convened pursuant to subsection 3, the panel shall hold an adjudicatory hearing. Upon completion of the adjudicatory hearing, the panel shall issue a decision or order to:

A. Take any action authorized by section 19124, subsection 1; Title 10, section 8003, subsection 5; or Title 10, section 8003-D; or

B. Dismiss the complaint.

9. Compensation. Members of a panel are entitled to reimbursement for travel expenses.

10. Panel meetings. A panel shall hold its first meeting at the request of the board. Subsequent meetings must be held at the request of the chair of the panel.

11. Quorum. Two members of a panel constitute a quorum.

12. Repeal. This section is repealed September 15, 2018.

SUBCHAPTER 3

DENTAL HYGIENISTS

§ 19141. Definition

A dental hygienist who practices under the supervision of a dentist of record may perform duties as defined and set forth in the rules of the board, except that nothing in this subchapter may be construed to affect the practice of medicine or dentistry or to prevent students of a dental college, university or school of dental hygiene from practicing dental hygiene under the supervision of their instructors.

§ 19142. Qualifications

A person 18 years of age or older who has successfully completed 2 years of training in a school of dental hygiene approved by the board, or who is a full-time dental student who has satisfactorily completed at least half of the prescribed course of study in an accredited dental college but has not graduated from a dental college, is eligible to apply for examination under section 19143.

§ 19143. Application; fee

An eligible person desiring to practice dental hygiene must make written application to the board to take the examination. The application must be accompanied by a fee to be determined by the board not to exceed $175. Applicants for licensure must pay a fee set by the board for the examination. The board may recognize a nationally or regionally administered examination for applicants to practice dental hygiene in the State.

§ 19144. License; biennial fee

The board shall issue a license to practice as a dental hygienist in this State to a person who has met the licensure requirements. The license must be exhibited publicly at the person's place of employment. The license authorizes practice as a dental hygienist in this State for the year in which it is issued until the expiration date that appears on the license. On or before January 1st of each odd-numbered year, the dental hygienist shall pay to the board a license renewal fee of not more than $175 to be determined by the board. Dental hygienists who have not paid the renewal fee on or before January 1st must be reinstated upon payment of a late fee of not more than $50 to be determined by the board if paid before February 1st of the year in which license renewal is due. Failure to be properly licensed by February 1st results in automatic suspension of a license to practice dental hygiene. Reinstatement may be made, if approved by the board, by payment to the secretary of the board of a fee determined by the board of not more than $175. A new applicant who has paid the application fee shall pay the biennial licensure fee if the applicant applies in an odd-numbered year or half the biennial licensure fee if the applicant applies in an even-numbered year.

The board may issue temporary licenses to dental hygienists who present credentials satisfactory to the board. The board may charge a fee of up to $25 for a temporary license.

§ 19145. Fee for duplicate license

An applicant for a duplicate license granted upon proof of loss of the original shall pay a fee of $15.

§ 19146. Continuing education

As a condition of renewal of a license to practice, a dental hygienist must submit evidence of successful completion of 30 hours of continuing education consisting of board-approved courses, including cardiopulmonary resuscitation courses, in the 2 years preceding the application for renewal. The board and the dental hygienist shall follow and are bound by the provisions of section 1084-A in the implementation of this section.

§ 19147. Mental or physical examination

For the purposes of this section, by application for and acceptance of a license to practice, a licensed dental hygienist is considered to have given consent to a mental or physical examination when directed by the board. The board may direct a dental hygienist to submit to an examination whenever the board determines the dental hygienist may be suffering from a mental illness that may be interfering with the competent practice of dental hygiene or from the use of intoxicants or drugs to an extent that they are preventing the dental hygienist from practicing dental hygiene competently and with safety to patients. A dental hygienist examined pursuant to an order of the board may not prevent the testimony of the examining individual or prevent the acceptance into evidence of the report of an examining individual. Failure to comply with an order of the board to submit to a mental or physical examination results in the immediate suspension of the license of the dental hygienist by order of the District Court until the dental hygienist submits to the examination.

§ 19148. Licensure requirements for graduates of accredited programs

In order to be licensed as a dental hygienist under this subchapter, a person who is a graduate of a dental hygiene program approved by the American Dental Association Commission on Dental Accreditation or its successor organization must meet one of the following 2 sets of requirements:

1. Standard licensure. For standard licensure, the applicant must:

A. Have received, at least, an associate degree from a dental hygiene program accredited by the American Dental Association Commission on Dental Accreditation or its successor organization and have provided a notarized statement from the dean of the school affirming that the applicant has met all applicable degree requirements;

B. Have completed with a passing grade the National Board Dental Hygiene Examination or the successor to that examination;

C. Have completed with a passing grade the North East Regional Board Dental Hygiene Examination or the successor to that examination;

D. Have completed with a passing grade the jurisprudence examination given by the board; and

E. For any applicant who has completed the North East Regional Board Dental Hygiene Examination or the successor to that examination more than one year prior to application for licensure in the State, have successfully completed a personal interview before the board; and

2. Licensure by endorsement. For licensure by endorsement, the applicant must:

A. Have graduated from an accredited dental hygiene program;

B. If the candidate graduated subsequent to 1964, have completed with a passing grade the National Board Dental Hygiene Examination or the successor to that examination if such an examination was required;

C. Have furnished proof, satisfactory to the board, that the candidate has been duly licensed to practice dental hygiene in another state after full compliance with its laws;

D. If the candidate graduated subsequent to 1970, have completed with a passing grade the North East Regional Board Dental Hygiene Examination or the successor to that examination if such an examination was required, except that the board may at its discretion waive the North East Regional Board Dental Hygiene Examination or the successor to that examination if all other requirements of this subsection have been met;

E. Have engaged in active clinical practice for a minimum of 3 years prior to application;

F. Have completed with a passing grade the jurisprudence examination given by the board; and

G. Have successfully completed a personal interview before the board.

The board may at its discretion waive the North East Regional Board Dental Hygiene Examination or the successor to that examination if all other requirements have been met.

§ 19149. Temporary filling procedures

A dental hygienist with public health supervision status, as defined by rules adopted by the board, may perform temporary filling procedures without a dentist present under protocols developed by the board.

§ 19150. Endorsement

The board may at its discretion, without examination, issue a license to an applicant to practice dental hygiene who furnishes proof satisfactory to the board that the applicant has been duly licensed for at least 3 years to practice in another state or a Canadian province after full compliance with the requirements of its dental laws, except that the professional education may not be less than is required in this State. The board may require letters of reference as to ability. An applicant for licensure by endorsement who meets the requirements of this section must be interviewed in person by the board prior to being issued a license. A license so given must state upon its face that it was granted on the basis of endorsement. The fee for that license must be determined by the board, but may not be more than $175.

§ 19151. Use of former employers' lists; scope of duties

A dental hygienist may not use or attempt to use in any manner whatsoever any prophylactic lists, call lists, records, reprints or copies of those lists, records or reprints, or information gathered from these materials, of the names of patients whom the dental hygienist might have served in the office of a prior employer, unless these names appear on the bona fide call or prophylactic list of the present employer and were caused to so appear through the legitimate practice of dentistry as provided for in chapter 16. A dentist may not aid or abet or encourage a dental hygienist in the dentist's employ to make use of a so-called prophylactic call list or to call by telephone or to use written letters transmitted through the mails to solicit patronage from patients formerly served in the office of a dentist formerly employing the dental hygienist.

A dentist may not permit a dental hygienist operating under the dentist's supervision to perform an operation other than that permitted under section 19141.

SUBCHAPTER 4

INDEPENDENT PRACTICE DENTAL HYGIENISTS

§ 19161. Independent practice

An independent practice dental hygienist licensed by the board pursuant to this subchapter may practice without supervision by a dentist to the extent permitted by this subchapter. Any licensee may be the proprietor of a place where independent practice dental hygiene is performed and may purchase, own or lease equipment necessary for the performance of independent practice dental hygiene.

A person practicing independent practice dental hygiene as an employee of another shall cause that person's name to be conspicuously displayed at the entrance of the place where the practice is conducted.

§ 19162. Qualifications for licensure

To qualify for licensure under this subchapter as an independent practice dental hygienist, a person must:

1. Eighteen years of age. Be 18 years of age or older;

2. Licensure as dental hygienist. Possess a valid license to practice dental hygiene issued by the board pursuant to subchapter 4 or qualify for licensure as an independent practice dental hygienist by endorsement pursuant to section 19164; and

3. Education and experience. Meet the educational and experience requirements described in section 19163.

§ 19163. Education and experience

An applicant for licensure under this subchapter as an independent practice dental hygienist must:

1. Bachelor's degree and 2,000 hours' experience. Possess a bachelor's degree in dental hygiene from a dental hygiene program accredited by the American Dental Association Commission on Dental Accreditation, or its successor organization, and document 2,000 work hours of clinical practice in a private dental practice or nonprofit dental clinic under direct or general supervision of a dentist during the 4 years preceding application; or

2. Associate degree and 5,000 hours' experience. Possess an associate degree in dental hygiene from a dental hygiene program accredited by the American Dental Association Commission on Dental Accreditation, or its successor organization, and document 5,000 work hours of clinical practice in a private dental practice or nonprofit dental clinic under direct or general supervision of a dentist during the 6 years preceding application.

§ 19164. Licensure by endorsement

A person eligible for licensure as a dental hygienist by endorsement pursuant to section 19148, subsection 2 or section 19150 is also eligible for licensure under this subchapter as an independent practice dental hygienist by endorsement if the applicant meets the educational and experience requirements set forth in section 19163.

§ 19165. Application

An applicant for licensure as an independent practice dental hygienist shall apply to the board on forms provided by the board. The applicant shall include as part of the application such information and documentation as the board may require to act on the application. The application must be accompanied by the application fee set under section 19167.

§ 19166. License; biennial renewal; discontinuation of dental hygienist license

The board shall issue a license to practice as an independent practice dental hygienist to a person who has met the requirements for licensure set forth in this subchapter and has paid the application fee under section 19167. There is an initial license fee for independent practice dental hygienists licensed by endorsement. The license must be exhibited publicly at the person's place of business or employment. The initial date of expiration of the license is the original expiration date of the person's dental hygienist license issued by the board pursuant to subchapter 1 or, for independent practice dental hygienists licensed by endorsement, January 1st of the first odd-numbered year following initial licensure. On or before January 1st of each odd-numbered year, the independent practice dental hygienist shall pay to the board a license renewal fee. Independent practice dental hygienists who have not paid the renewal fee on or before January 1st must be reinstated upon payment of a late fee before February 1st of the year in which license renewal is due. Failure to be properly licensed by February 1st results in automatic suspension of a license to practice as an independent practice dental hygienist. Reinstatement of the independent practice dental hygienist license may be made, if approved by the board, by payment of a reinstatement fee to the board.

A dental hygienist license issued by the board pursuant to subchapter 3 automatically expires upon issuance under this subchapter of an independent practice dental hygienist license to the same person.

§ 19167. Fees

The board may establish by rule fees for purposes authorized under this subchapter in amounts that are reasonable and necessary for their respective purposes, except that the fee for any one purpose may not exceed $275. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.

§ 19168. Continuing education

As a condition of renewal under this subchapter of a license to practice, an independent practice dental hygienist must submit evidence of successful completion of 30 hours of continuing education consisting of board-approved courses in the 2 years preceding the application for renewal. The board and the independent practice dental hygienist shall follow and are bound by the provisions of section 1084-A in the implementation of this section.

Continuing education completed pursuant to section 19146 may be recognized for purposes of this section in connection with the first renewal of an independent practice dental hygienist license.

The board may refuse to issue a license under this subchapter to a person who has not completed continuing education required by section 19146 or may issue the license on terms and conditions set by the board.

§ 19169. Scope of practice

1. Independent practice. An independent practice dental hygienist licensed under this subchapter may perform only the following duties without supervision by a dentist:

A. Interview patients and record complete medical and dental histories;

B. Take and record the vital signs of blood pressure, pulse and temperature;

C. Perform oral inspections, if the independent practice dental hygienist records all conditions that should be called to the attention of a dentist;

D. Perform complete periodontal and dental restorative charting;

E. Perform all procedures necessary for a complete prophylaxis, including root planing;

F. Apply fluoride to control caries;

G. Apply desensitizing agents to teeth;

H. Apply topical anesthetics;

I. Apply sealants;

J. Smooth and polish amalgam restorations, limited to slow speed application only;

K. Cement pontics and facings outside the mouth;

L. Take impressions for athletic mouth guards and custom fluoride trays;

M. Place and remove rubber dams;

N. Place temporary restorations in compliance with the protocol adopted by the board; and

O. Apply topical antimicrobials, excluding antibiotics, including fluoride, for the purposes of bacterial reduction, caries control and desensitization in the oral cavity. The independent practice dental hygienist shall follow current manufacturer's instructions in the use of these medicaments.

For the purposes of this subsection, "topical" includes superficial and intraoral application.

2. Practice under supervision. An independent practice dental hygienist licensed under this subchapter may perform duties under the supervision of a dentist as set forth in the rules of the board pursuant to section 19141.

§ 19170. Responsibilities

An independent practice dental hygienist licensed under this subchapter has the duties and responsibilities set out in this section with respect to each patient seen in an independent capacity pursuant to section 19169, subsection 1.

1. Acknowledgment. Prior to an initial patient visit, an independent practice dental hygienist licensed under this subchapter shall obtain from the patient or the parent or guardian of a minor patient written acknowledgment of the patient's or parent's or guardian's understanding that the independent practice dental hygienist is not a dentist and that the service to be rendered does not constitute restorative care or treatment.

2. Referral plan. An independent practice dental hygienist licensed under this subchapter shall provide to a patient or the parent or guardian of a minor patient a written plan for referral to a dentist for any necessary dental care. The referral plan must identify all conditions that should be called to the attention of the dentist.

§ 19171. Mental or physical examination

For the purposes of this section, by application for and acceptance of a license to practice under this subchapter, an independent practice dental hygienist is considered to have given consent to a mental or physical examination when directed by the board. The board may direct an independent practice dental hygienist to submit to an examination whenever the board determines the independent practice dental hygienist may be suffering from a mental illness that may be interfering with the competent independent practice of dental hygiene or from the use of intoxicants or drugs to an extent that they are preventing the independent practice dental hygienist from practicing dental hygiene competently and with safety to patients. An independent practice dental hygienist examined pursuant to an order of the board may not prevent the testimony of the examining individual or prevent the acceptance into evidence of the report of an examining individual. Failure to comply with an order of the board to submit to a mental or physical examination results in the immediate suspension of the license to practice independent dental hygiene by order of the District Court until the independent practice dental hygienist submits to the examination.

§ 19172. Use of former employers' lists

An independent practice dental hygienist may not use or attempt to use in any manner whatsoever any prophylactic lists, call lists, records, reprints or copies of those lists, records or reprints, or information gathered from these materials, of the names of patients whom the independent practice dental hygienist might have served in the office of a prior employer, unless these names appear on the bona fide call or prophylactic list of the present employer and were caused to so appear through the independent practice of dentistry, denturism or independent practice dental hygiene as provided for in this chapter and chapter 16. A dentist, denturist or independent practice dental hygienist who employs an independent practice dental hygienist may not aid or abet or encourage that independent practice dental hygienist to make use of a so-called prophylactic call list or to call by telephone or to use written letters transmitted through the mails to solicit patronage from patients formerly served in the office of a dentist, denturist or independent practice dental hygienist that formerly employed the independent practice dental hygienist.

Sec. 22. Maine Revised Statutes headnote amended; revision clause. In the Maine Revised Statutes, Title 32, chapter 16, in the chapter headnote, the words "dentists and dental hygienists" are amended to read "dentists" and the Revisor of Statutes shall implement this revision when updating, publishing or republishing the statutes.

Sec. 23. Transition provisions.

1. Licenses. A person who on the effective date of this Act holds a valid dental hygienist license issued by the State Board of Dental Examiners maintains that license until time of renewal. At time of renewal, the licensee shall file an application with the State Board of Dental Hygienists to obtain a new license.

2. Board members. Dental hygienist board members serving on the State Board of Dental Examiners on the effective date of this Act continue to serve on the board until their successors are appointed.

SUMMARY

This bill establishes the State Board of Dental Hygienists.

HP0657 LD 933	Session - 126th Maine Legislature		LR 129 Item 1
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