1.1 	A bill for an act
1.2 	relating to health occupations; modifying dental
1.3 	licensure provisions; establishing fees; amending
1.4 	Minnesota Statutes 2004, sections 150A.01, subdivision
1.5 	6a; 150A.06, subdivision 1a; 150A.10, subdivision 1a;
1.6 	proposing coding for new law in Minnesota Statutes,
1.7 	chapter 150A.
1.8 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.9 	Section 1. Minnesota Statutes 2004, section 150A.01,
1.10 	subdivision 6a, is amended to read:
1.11 		Subd. 6a.Faculty dentist.  "Faculty dentist" means a
1.12 	person who is licensed to practice dentistry as a faculty member
1.13 	of a school of dentistry, pursuant to section 150A.06,
1.14 	subdivision 1a.

1.15 	Sec. 2. Minnesota Statutes 2004, section 150A.06,
1.16 	subdivision 1a, is amended to read:
1.17 		Subd. 1a.Faculty dentists.  (a) Faculty members of a
1.18 	school of dentistry must be licensed in order to practice
1.19 	dentistry as defined in section 150A.05.  The board may issue to
1.20 	members of the faculty of a school of dentistry a license
1.21 	designated as either a "limited faculty license" or a "full
1.22 	faculty license" entitling the holder to practice dentistry
1.23 	within the terms described in paragraph (b) or (c).  The dean of
1.24 	a school of dentistry and program directors of a Minnesota
1.25 	dental hygiene or dental assisting school accredited by the
1.26 	Commission on Dental Accreditation of the American Dental
2.1 	Association shall certify to the board those members of the
2.2 	school's faculty who practice dentistry but are not licensed to
2.3 	practice dentistry in Minnesota.  A faculty member who practices
2.4 	dentistry as defined in section 150A.05, before beginning duties
2.5 	in a school of dentistry or a dental hygiene or dental assisting
2.6 	school, shall apply to the board for a limited or full faculty
2.7 	license. The license expires the next July 1 and may, at the
2.8 	discretion of the board, be renewed on a yearly basis.Pursuant
2.9 	to Minnesota Rules, chapter 3100, and at the discretion of the
2.10 	board, a limited faculty license must be renewed annually and a
2.11 	full faculty license must be renewed biennially.The faculty
2.12 	applicant shall pay a nonrefundable fee set by the board for
2.13 	issuing and renewing the faculty license.  The faculty license
2.14 	is valid during the time the holder remains a member of the
2.15 	faculty of a school of dentistry or a dental hygiene or dental
2.16 	assisting school and subjects the holder to this chapter.
2.17 	(b) The board may issue to dentist members of the faculty
2.18 	of a Minnesota school of dentistry, dental hygiene, or dental
2.19 	assisting accredited by the Commission on Dental Accreditation
2.20 	of the American Dental Association, a license designated as a
2.21 	limited faculty license entitling the holder to practice
2.22 	dentistry within the school and its affiliated teaching
2.23 	facilities, but only for the purposes of teaching or conducting
2.24 	research.  The practice of dentistry at a school facility for
2.25 	purposes other than teaching or research is not allowed unless
2.26 	the dentist was a faculty member on August 1, 1993.
2.27 	(c) The board may issue to dentist members of the faculty
2.28 	of a Minnesota school of dentistry, dental hygiene, or dental
2.29 	assisting accredited by the Commission on Dental Accreditation
2.30 	of the American Dental Association a license designated as a
2.31 	full faculty license entitling the holder to practice dentistry
2.32 	within the school and its affiliated teaching facilities and
2.33 	elsewhere if the holder of the license is employed 50 percent
2.34 	time or more by the school in the practice of teaching or
2.35 	research, and upon successful review by the board of the
2.36 	applicant's qualifications as described in subdivisions 1, 1c,
3.1 	and 4 and board rule.  The board, at its discretion, may waive
3.2 	specific licensing prerequisites.

3.3 	Sec. 3. [150A.091] FEES.
3.4 		Subdivision 1.Fee refunds. No fee may be refunded for
3.5 	any reason.
3.6 		Subd. 2.Application fees. Each applicant for licensure
3.7 	or registration shall submit with a license or registration
3.8 	application a nonrefundable fee in the following amounts in
3.9 	order to administratively process an application:
3.10 	(1) dentist, $140;
3.11 	(2) limited faculty dentist, $140;
3.12 	(3) resident dentist, $55;
3.13 	(4) dental hygienist, $55;
3.14 	(5) registered dental assistant, $35; and 
3.15 	(6) dental assistant with a limited registration, $15.
3.16 		Subd. 3.Initial license or registration fees. Along
3.17 	with the application fee, each of the following licensees or
3.18 	registrants shall submit a separate prorated initial license or
3.19 	registration fee.  The prorated initial fee shall be established
3.20 	by the board based on the number of months of the licensee's or
3.21 	registrant's initial term as described in Minnesota Rules, part
3.22 	3100.1700, subpart 1a, not to exceed the following monthly fee
3.23 	amounts:
3.24 	(1) dentist, $14 times the number of months of the initial
3.25 	term;
3.26 	(2) dental hygienist, $5 times the number of months of the
3.27 	initial term;
3.28 	(3) registered dental assistant, $3 times the number of
3.29 	months of initial term; and 
3.30 	(4) dental assistant with a limited registration, $1 times
3.31 	the number of months of the initial term.
3.32 		Subd. 4.Annual license fees. Each limited faculty or
3.33 	resident dentist shall submit with an annual license renewal
3.34 	application a fee established by the board not to exceed the
3.35 	following amounts:
3.36 	(1) limited faculty dentist, $168; and 
4.1 	(2) resident dentist, $59.
4.2 		Subd. 5.Biennial license or registration fees. Each of
4.3 	the following licensees or registrants shall submit with a
4.4 	biennial license or registration renewal application a fee as
4.5 	established by the board, not to exceed the following amounts:
4.6 	(1) dentist, $336;
4.7 	(2) dental hygienist, $118;
4.8 	(3) registered dental assistant, $80; and 
4.9 	(4) dental assistant with a limited registration, $24.
4.10 		Subd. 6.Annual license late fee. Applications for
4.11 	renewal of any license received after the time specified in
4.12 	Minnesota Rules, part 3100.1750, must be assessed a late fee
4.13 	equal to 50 percent of the annual renewal fee.
4.14 		Subd. 7.Biennial license or registration late
4.15 	fee. Applications for renewal of any license or registration
4.16 	received after the time specified in Minnesota Rules, part
4.17 	3100.1700, must be assessed a late fee equal to 25 percent of
4.18 	the biennial renewal fee.
4.19 		Subd. 8.Duplicate license or registration fee. Each
4.20 	licensee or registrant shall submit, with a request for issuance
4.21 	of a duplicate of the original license or registration, or of an
4.22 	annual or biennial renewal of it, a fee in the following amounts:
4.23 	(1) original dentist or dental hygiene license, $35; and 
4.24 	(2) initial and renewal registration certificates and
4.25 	license renewal certificates, $10.
4.26 		Subd. 9.Licensure and registration by credentials. Each
4.27 	applicant for licensure as a dentist or dental hygienist or for
4.28 	registration as a registered dental assistant by credentials
4.29 	pursuant to section 150A.06, subdivisions 4 and 8, and Minnesota
4.30 	Rules, part 3100.1400, shall submit with the license or
4.31 	registration application a fee in the following amounts:
4.32 	(1) dentist, $725;
4.33 	(2) dental hygienist, $175; and 
4.34 	(3) registered dental assistant, $35.
4.35 		Subd. 10.Reinstatement fee. No dentist, dental
4.36 	hygienist, or registered dental assistant whose license or
5.1 	registration has been suspended or revoked may have the license
5.2 	or registration reinstated or a new license or registration
5.3 	issued until a fee has been submitted to the board in the
5.4 	following amounts:
5.5 	(1) dentist, $140;
5.6 	(2) dental hygienist, $55; and 
5.7 	(3) registered dental assistant, $35.
5.8 		Subd. 11.Certificate application fee for
5.9 	anesthesia/sedation. Each dentist shall submit with a general
5.10 	anesthesia or conscious sedation application a fee as
5.11 	established by the board not to exceed the following amounts:
5.12 	(1) for both a general anesthesia and conscious sedation
5.13 	application, $50;
5.14 	(2) for a general anesthesia application only, $50; and 
5.15 	(3) for a conscious sedation application only, $50.
5.16 		Subd. 12.Duplicate certificate fee for
5.17 	anesthesia/sedation. Each dentist shall submit with a request
5.18 	for issuance of a duplicate of the original general anesthesia
5.19 	or conscious sedation certificate a fee in the amount of $10.
5.20 		Subd. 13.On-site inspection fee. An on-site inspection
5.21 	fee must be paid to the individual, organization, or agency
5.22 	conducting the inspection and be limited to a maximum fee as
5.23 	determined by the board.  Travel, lodging, and other expenses
5.24 	are not part of the on-site inspection fee.
5.25 		Subd. 14.Affidavit of licensure. Each licensee or
5.26 	registrant shall submit with a request for an affidavit of
5.27 	licensure a fee in the amount of $10.
5.28 		Subd. 15.Verification of licensure. Each institution or
5.29 	corporation shall submit with a request for verification of a
5.30 	license or registration a fee in the amount of $5 for each
5.31 	license or registration to be verified.
5.32 	
EFFECTIVE DATE. Subdivisions 11 and 12 are effective
5.33 	........

5.34 	Sec. 4. Minnesota Statutes 2004, section 150A.10,
5.35 	subdivision 1a, is amended to read:
5.36 		Subd. 1a.Limited authorization for dental hygienists.
 6.1 	(a) Notwithstanding subdivision 1, a dental hygienist licensed
6.2 	under this chapter may be employed or retained by a health care
6.3 	facility, program, or nonprofit organization to perform dental
6.4 	hygiene services described under paragraph (b) without the
6.5 	patient first being examined by a licensed dentist if the dental
6.6 	hygienist:
6.7 	(1) has been engaged in the active practice of clinical
6.8 	dental hygiene for not less than 2,400 hours in the past 18
6.9 	months or a career total of 3,000 hours, including a minimum of
6.10 	200 hours of clinical practice in two of the past three years;
6.11 	(2) has entered into a collaborative agreement with a
6.12 	licensed dentist that designates authorization for the services
6.13 	provided by the dental hygienist;
6.14 	(3) has documented participation in courses in infection
6.15 	control and medical emergencies within each continuing education
6.16 	cycle; and
6.17 	(4) maintains current certification in advanced or basic
6.18 	cardiac life support as recognized by the American Heart
6.19 	Association, the American Red Cross, or another agency that is
6.20 	equivalent to the American Heart Association or the American Red
6.21 	Cross.
6.22 	(b) The dental hygiene services authorized to be performed
6.23 	by a dental hygienist under this subdivision are limited to:
6.24 	(1) oral health promotion and disease prevention education;
6.25 	(2) removal of deposits and stains from the surfaces of the
6.26 	teeth;
6.27 	(3) application of topical preventive or prophylactic
6.28 	agents, including fluoride varnishes and pit and fissure
6.29 	sealants;
6.30 	(4) polishing and smoothing restorations;
6.31 	(5) removal of marginal overhangs;
6.32 	(6) performance of preliminary charting;
6.33 	(7) taking of radiographs; and
6.34 	(8) performance of scaling and root planing.
6.35 	The dental hygienist shall not perform injections of anesthetic
6.36 	agents or the administration of nitrous oxide unless under the
7.1 	indirect general supervision of a licensed dentist.
7.2 	Collaborating dental hygienists may work with unregistered and
7.3 	registered dental assistants who may only perform duties for
7.4 	which registration is not required.  The performance of dental
7.5 	hygiene services in a health care facility, program, or
7.6 	nonprofit organization as authorized under this subdivision is
7.7 	limited to patients, students, and residents of the facility,
7.8 	program, or organization.
7.9 	(c) A collaborating dentist must be licensed under this
7.10 	chapter and may enter into a collaborative agreement with no
7.11 	more than four dental hygienists unless otherwise authorized by
7.12 	the board.  The board shall develop parameters and a process for
7.13 	obtaining authorization to collaborate with more than four
7.14 	dental hygienists.  The collaborative agreement must include:
7.15 	(1) consideration for medically compromised patients and
7.16 	medical conditions for which a dental evaluation and treatment
7.17 	plan must occur prior to the provision of dental hygiene
7.18 	services;
7.19 	(2) age- and procedure-specific standard collaborative
7.20 	practice protocols, including recommended intervals for the
7.21 	performance of dental hygiene services and a period of time in
7.22 	which an examination by a dentist should occur;
7.23 	(3) copies of consent to treatment form provided to the
7.24 	patient by the dental hygienist;
7.25 	(4) specific protocols for the placement of pit and fissure
7.26 	sealants and requirements for follow-up care to assure the
7.27 	efficacy of the sealants after application; and
7.28 	(5) a procedure for creating and maintaining dental records
7.29 	for the patients that are treated by the dental hygienist.  This
7.30 	procedure must specify where these records are to be located.
7.31 	The collaborative agreement must be signed and maintained by the
7.32 	dentist, the dental hygienist, and the facility, program, or
7.33 	organization; must be reviewed annually by the collaborating
7.34 	dentist and dental hygienist; and must be made available to the
7.35 	board upon request.
7.36 	(d) Before performing any services authorized under this
8.1 	subdivision, a dental hygienist must provide the patient with a
8.2 	consent to treatment form which must include a statement
8.3 	advising the patient that the dental hygiene services provided
8.4 	are not a substitute for a dental examination by a licensed
8.5 	dentist.  If the dental hygienist makes any referrals to the
8.6 	patient for further dental procedures, the dental hygienist must
8.7 	fill out a referral form and provide a copy of the form to the
8.8 	collaborating dentist.
8.9 	(e) For the purposes of this subdivision, a "health care
8.10 	facility, program, or nonprofit organization" is limited to a
8.11 	hospital; nursing home; home health agency; group home serving
8.12 	the elderly, disabled, or juveniles; state-operated facility
8.13 	licensed by the commissioner of human services or the
8.14 	commissioner of corrections; and federal, state, or local public
8.15 	health facility, community clinic, tribal clinic, school
8.16 	authority, Head Start program, or nonprofit organization that
8.17 	serves individuals who are uninsured or who are Minnesota health
8.18 	care public program recipients.
8.19 	(f) For purposes of this subdivision, a "collaborative
8.20 	agreement" means a written agreement with a licensed dentist who
8.21 	authorizes and accepts responsibility for the services performed
8.22 	by the dental hygienist.  The services authorized under this
8.23 	subdivision and the collaborative agreement may be performed
8.24 	without the presence of a licensed dentist and may be performed
8.25 	at a location other than the usual place of practice of the
8.26 	dentist or dental hygienist and without a dentist's diagnosis
8.27 	and treatment plan, unless specified in the collaborative
8.28 	agreement.