HB 452-FN – AS INTRODUCED
2011 SESSION
10/05
HOUSE BILL 452-FN
AN ACT establishing the independent regulation of dental hygienists.
SPONSORS: Rep. Cebrowski, Hills 18; Rep. C. McGuire, Merr 8; Rep. DiPentima, Rock 16; Sen. Odell, Dist 8; Sen. Houde, Dist 5
COMMITTEE: Executive Departments and Administration
This bill establishes a governing board of dental hygiene under the allied health professionals for the independent regulation of dental hygienists, and removes provisions for dental hygienist regulation by the board of dental examiners.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
11-0230
10/05
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eleven
AN ACT establishing the independent regulation of dental hygienists.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Chapter; Dental Hygiene Practice Act. Amend RSA by inserting after chapter 317-A the following new chapter:
CHAPTER 317-B
317-B:1 Purpose. In order to safeguard the life, health, and public welfare of the people of New Hampshire and in order to protect the people of the state from the unauthorized, unqualified, and improper application of services by individuals in the practice of dental hygiene, it is necessary that a regulatory authority be established and adequately funded. To further this policy, the practice of dental hygiene shall be regulated through the New Hampshire board of dental hygiene, and such board shall have the power to enforce the provisions of this chapter. Licensees under this chapter are accountable to clients, the dental hygiene profession, and the board for complying with the requirements of this chapter and the quality of dental hygiene rendered, and for recognizing limits of knowledge and experience and planning for management of situations beyond the licensee’s experience.
317-B:2 Definitions. In this chapter:
I. “Board” means the board of dental hygiene established as a governing board in RSA 328-F.
II. “Continuing competence” means integrated learning by which a licensee gains, maintains, or refines practice knowledge, skills, and abilities. This development may occur through a formal education program, continuing education, and clinical practice, and is expected to continue throughout the practitioners’ career.
III. “Dental hygienist” means an individual who is licensed by the board to practice dental hygiene.
IV. “Dental hygiene” means the scope of services described in RSA 317-B:8.
317-B:3 Board of Dental Hygiene.
I. The board of dental hygiene shall be a governing board under the allied health professionals board established under RSA 328-F.
II. Each dental hygienist member of the board shall be a resident of this state, licensed in good standing under the provisions of this chapter, and currently engaged in the practice of dental hygiene and shall have no fewer than 5 years of experience as a dental hygienist, at least 3 of which shall have immediately preceded appointment.
III. Notwithstanding RSA 328-F:5, each member of the board shall be compensated at the rate of $100 for attendance at a regular board meeting and $50 for each other day actually engaged in official duties of the board, and shall be reimbursed for actual and necessary expenses incurred in the discharge of official duties, including travel at the state employee mileage rate.
IV. An appointee to a full term on the board shall be appointed by the governor with the consent of the council before the expiration of the term of the member being succeeded and shall become a member of the board on the first day following the appointment expiration date of the previous appointee. Appointees to unexpired portions of full terms shall become members of the board on the day following such appointment, and shall serve the unexpired term and then be eligible to serve 3 full 3-year terms.
V. All members of the board and its agents or employees shall enjoy immunity from individual civil liability while acting within the scope of their duties as board members, agents, or employees, as long as they are not acting in a wanton or reckless manner.
VI. Board meetings shall be open to the public. In accordance with RSA 91-A:3, the board may conduct part of a meeting in nonpublic session.
317-B:4 Powers and Duties of the Board. In addition to the provisions of RSA 328-F, the board may:
I. Establish reasonable and uniform standards for dental hygiene practice consistent with the criteria identified by the American Dental Hygienists’ Association (ADHA) Standards.
II. Provide consultation regarding dental hygiene practice for institutions and agencies and investigate reports of illegal practice.
III. Examine, license, and renew the licenses of duly qualified individuals. The board shall select an appropriate nationally approved licensing examination.
IV. Gather and report to the public statistical information regarding, but not limited to, the education and licensure of dental hygienists licensed to practice in this state.
V. Conduct investigations, hearings, and proceedings concerning alleged violations of this chapter or of rules adopted under this chapter.
VI. Subpoena witnesses, records, and documents, as needed, and administer oaths to those testifying at hearings.
VII. Determine and enforce appropriate disciplinary action against all individuals found guilty of violating this chapter or the rules adopted under this chapter.
VIII. Deny or withdraw approval of dental hygiene educational programs that do not meet the minimum requirements of this chapter.
IX. Maintain records of proceedings as required by the laws of New Hampshire.
X. Conduct conferences, forums, studies, and research on dental hygiene practice and education.
XI. Obtain legal counsel, hearing officers, accountants and such other employees, assistants, and agents as may be necessary, in the opinion of the board to administer and enforce the provisions of this chapter.
XII. Establish and collect fees, under rules adopted by the board under RSA 328-F and RSA 541-A, relative to applicants seeking any type of license issued by the board under this chapter, including fees for applications for temporary licenses, reinstatement of inactive licenses, licenses by examination, and renewal of licenses, as well as fees for verifying license status, program graduation, or computerized lists.
XIII. In accordance with state due process laws, take any other actions under applicable state laws necessary to protect the health and safety of New Hampshire citizens.
317-B:5 Collection and Expenditure of Funds. The board shall receive and expend funds provided such funds are received and expended for the pursuit of the objectives authorized by this chapter.
317-B:6 Fees; Charges.
I. The board shall charge fees for the issuance, renewal, and reinstatement of all licenses authorized by this chapter. The board shall recover at least 125 percent of its direct expenses through licensee fees, fines, and administrative charges.
II. The board may provide the following services and make administrative charges for:
(a) The administration of examinations required by this chapter.
(b) Verification of licensure status.
(c) The sale of lists of licensees who have given their written authorization to have their names included on such lists.
317-B:7 Rulemaking Authority. The board shall adopt rules, in accordance with RSA 328-F and RSA 541-A, relative to the following:
I. Application procedures and eligibility requirements for the issuance of all initial, temporary, and renewal licenses issued by the board, including the issuance of such licenses to applicants holding a currently valid license or other authorization to practice in another jurisdiction.
II. Application procedures and eligibility requirements for the reinstatement of licenses after lapse and after disciplinary action.
III. Recognition of national certifying bodies issuing specialty certifications required for licensure as a dental hygienist.
IV. The standards to be met by, and the process for approval of, education programs designed to prepare applicants to qualify for licensure or certification in any of the disciplines regulated by the board, including the time period within which noncompliance must be corrected before such approval is withdrawn.
V. The determination of disciplinary sanctions authorized by this chapter, including the determination of administrative fines.
VI. The administration of examinations authorized by this chapter, and the manner in which information regarding the contents of any licensing examinations may be disclosed, solicited, or compiled.
VII. Ethical standards for the practice of dental hygiene activities.
VIII. Continuing competence requirements.
IX. Designations that may be used by persons regulated by the board.
317-B:8 Scope of Practice; Dental Hygienist.
I. A dental hygienist may practice dental hygiene in all settings, guided by standards consistent with standards established by or approved by the board.
II. A person shall be regarded as practicing dental hygiene within the meaning of this chapter, who performs any of the actions listed in paragraph III or who uses the title “registered dental hygienist”, the abbreviation “R.D.H.”, or any other words or symbols that indicate that the person is a licensed dental hygienist.
III. Dental hygiene services shall include:
(a) The assessment of medical and dental histories, including preliminary inspection of the oral cavity, surrounding structures, and periodontal charting.
(b) The assessment of the patient to collect and evaluate complete data to identify dental hygiene care needs.
(c) The performance of the complete prophylaxis including the removal of calciferous deposits, excess cements, excess bond materials from orthodontic appliances, accretions, and stains from the supragingival and subgingival surfaces of the teeth by scaling, root planning, and polishing.
(d) The performance of procedures requiring additional education and any other procedures authorized by the board through rules adopted under RSA 541-A.
(e) The administration of local anesthesia.
(f) The administration of nitrous oxide/oxygen minimal sedation (anxiolysis); provided the dental hygienist is qualified by the board after training and after passing an examination approved by the board.
(g) Other dental hygiene services that require education and training prescribed by the board and in conformance with national dental hygiene standards. Additional dental hygiene services shall be commensurate with the dental hygienist’s experience, continuing education, and demonstrated competencies.
317-B:9 Practice Limitations. Nothing in this chapter shall be construed to permit the independent practice of dental hygienists.
317-B:10 Non-practice. None of the following procedures may be assigned to a dental hygienist or assistant or to any other person not licensed to practice dentistry:
I. Diagnosis, treatment planning and prescriptions, including prescriptions for drugs and medicaments or authorization for restorative, prosthodontic, or orthodontic appliances.
II. Surgical procedures on hard or soft tissues within the oral cavity; or any other inter-oral procedure that contributes to, or results in, an irremediable alteration of the oral anatomy.
317-B:11 Criminal History Record Checks.
I. Every applicant for initial licensure shall submit to the board a notarized criminal history record release form, as provided by the New Hampshire division of state police, department of safety, which authorizes the release of his or her criminal history record, if any, to the board.
II. The applicant shall submit with the release form a complete set of fingerprints taken by a qualified law enforcement agency or an authorized employee of the department of safety. In the event that the first set of fingerprints is invalid due to insufficient pattern, a second set of fingerprints shall be necessary in order to complete the criminal history records check. If, after 2 attempts, a set of fingerprints is invalid due to insufficient pattern, the board may, in lieu of the criminal history records check, accept police clearances from every city, town, or county where the person has lived during the past 5 years.
III. The board shall submit the criminal history records release form and fingerprint form to the division of state police which shall conduct a criminal history records check through its records and through the Federal Bureau of Investigation. Upon completion of the records check, the division of state police shall release copies of the criminal history records to the board. The board shall maintain the confidentiality of all criminal history records information received pursuant to this section.
IV. The applicant shall bear the cost of a criminal history record check.
317-B:12 Licensure. All applicants shall:
I. Submit a completed application and fees as established by the board.
II. Have the ability to read and write in the English language.
III. Report any pending criminal charges, criminal convictions, or plea arrangement in lieu of convictions.
IV. Have committed no acts or omissions which are grounds for disciplinary action as set forth in this chapter, or, if such acts have been committed and would be grounds for disciplinary action, the board has found, after investigation, that sufficient restitution has been made.
V. Meet continuing competence requirements as defined in rules adopted under RSA 541-A.
VI. Meet other criteria as established by the board.
317-B:13 Dental Hygienist Initial License by Examination.
I. No person shall provide dental hygiene services in New Hampshire or use any sign, card, device or the abbreviation R.D.H. or any other designation indicating such person is providing dental hygiene services, unless such person has been licensed under the provisions of this chapter.
II. The board shall have the authority to grant a license to an applicant who has passed a clinical dental hygiene examination administered by or approved by the board, or to an applicant who has passed a national written dental hygiene examination approved by the board, where the applicant has passed an additional oral, clinical, written examinations required at the discretion of the board. No license shall be granted to any applicant who shall not pass such examinations satisfactorily.
III. Applications for licensure as a dental hygienist shall be made to the board in writing and shall be accompanied by a fee established by the board and by satisfactory proof that the applicant is a graduate of school of dental hygiene with a minimum of a 2-year program in an institution of higher education, the program of which is accredited by the Commission on Dental Accreditation of the American Dental Association, and approved by the board.
317-B:14 License by Endorsement. Licensure by endorsement may be considered by the board for each applicant who holds a current, unrestricted license to practice dental hygiene, who has graduated from a school of dental hygiene accredited by the Commission on Dental Accreditation and who has successfully completed a regional board examination.
317-B:15 License Renewal.
I. All license renewals shall be issued biennially as provided in RSA 328-F:19.
II. Any person licensed who intends to continue practicing as a dental hygienist shall:
(a) Submit a completed application and fees as established by the board;
(b) Report any pending criminal charges, criminal convictions, or plea arrangements in lieu of convictions;
(c) Have committed no acts or omissions which are grounds for disciplinary action as set forth in this chapter, or, if such acts have been committed and would be grounds for disciplinary action, the board has found, after investigation, that sufficient restitution has been made;
(d) Meet continuing competence requirements as defined in rules adopted under RSA 541-A;
(e) For those licensees applying for renewal following disciplinary action, comply with all board licensure requirements as well as any specific requirements set forth in the board’s discipline order; and
(f) Meet other criteria as established by the board.
III. Failure to renew the license shall result in forfeiture of the ability to practice dental hygiene activities in the state of New Hampshire.
317-B:16 License Reinstatement. An individual whose license has lapsed by failure to renew may apply for reinstatement by meeting all requirements for renewal, or satisfying the following conditions:
I. An individual who applies for license reinstatement who does not meet the continuing competence requirements shall demonstrate current dental hygiene knowledge and skill, as defined in rules adopted by the board under RSA 541-A.
II. For those licensees applying for reinstatement following disciplinary action, compliance with all board licensure requirements as well as any specific requirements set forth in the board’s discipline order.
III. Application for reinstatement of a license which has lapsed under this section shall include payment of a reinstatement fee and be made, and granted or denied, in accordance with rules adopted by the board pursuant to RSA 541-A.
317-B:17 Obligations of Licensees.
I. In response to board inquiries relevant to a licensee’s status or practice of dental hygiene activities, each licensee shall provide complete and truthful information.
II. Each licensee shall notify the board if a license is lost or stolen.
III. Each licensee shall notify the board of a change of name or address within 10 days.
IV. Each licensee shall report to the board those acts or omissions which are violations of this chapter or grounds for disciplinary action.
V. Each licensee shall display the license at all times in a conspicuous place in the office where the licensee practices, and shall, whenever requested, exhibit such license to any of the members of said board or its authorized agent.
317-B:18 Continuing Education. Applicants for license renewal and license reinstatement after lapse shall show proof of completing continuing education hours in programs approved by the board each year.
317-B:19 Disciplinary Action; Misconduct. The following shall apply in addition to any authority under RSA 328-F:23:
I. The board may undertake adjudicatory proceedings or proceedings to determine the qualifications of applicants for licensure:
(a) Upon its own initiative; or
(b) Upon written complaint of any person which charges that a person licensed by the board has committed misconduct under paragraph II of this section and specifies the grounds therefor, or charges that an applicant for a license lacks necessary qualifications and specifies the grounds therefor.
II. The board, after notice and the opportunity to be heard, may refuse to issue a license or impose sanctions against a licensee, when it has evidence that the licensee or applicant has engaged in professional misconduct. Misconduct sufficient to support adverse action shall include:
(a) Addiction to mind-altering drugs or intoxicants.
(b) Commission of any felony or of a misdemeanor involving dishonesty, untrustworthiness, or unprofessional conduct, or any administrative or criminal conviction involving moral turpitude or fraud in obtaining educational credentials, examination scores, or professional licensure in this or any other jurisdiction.
(c) Affliction with a physical or mental impairment or disease which is dangerous to the public health or which precludes the practice of dental hygiene at ordinary levels of proficiency.
(d) Ignorance, incompetence, or a pattern of behavior inconsistent with the basic knowledge and skills expected of persons licensed to practice dental hygiene.
(e) Gross or repeated negligence in practicing dental hygiene.
(f) Intentionally injuring a patient or engaging in any other unprofessional or dishonest conduct in practicing dental hygiene.
(g) Failure to follow the currently accepted standard of care as adopted, in whole or in part, by the board, regarding:
(1) Dental hygiene process of care; and
(2) Infection control; and
(3) Radiographic procedures.
(h) Knowingly or willfully violating any provision of this chapter, any substantive rule or order of the board, any federal, state or local controlled drug law or other federal, state, or local laws or regulations pertaining to the practice of dental hygiene, and the code of ethics of the American Dental Hygiene Association and Standards of Clinical Dental Hygiene Practice as reviewed and approved, in whole or in part, by the board.
III. The board may take disciplinary action in any one or more of the following ways:
(a) By license revocation or suspension.
(b) By limitation or restriction of a license.
(c) By requiring the licensee to submit to the care, counseling or treatment of a physician, counseling service, health care facility, professional assistance program, or any comparable person or facility, approved by the board.
(d) By requiring the licensee to participate in educational programs relevant to the practice of dentistry in substantive areas in which the licensee has been found professionally deficient.
(e) By requiring the licensee to practice under the direction of a dentist in a public institution, public or private health care program, or private practice for a period of time specified by the board under rules adopted pursuant to RSA 541-A.
(f) By assessing administrative fines in amounts established by the board which shall not exceed $2,000 per offense or, in the case of continuing offenses, $250 for each day the violation continues.
(g) By reprimand.
IV. Upon receipt of an administratively final order from the licensing authority of another jurisdiction which imposed disciplinary sanctions against any person licensed by the board, or any person applying for licensure, the board may issue an order directing the licensee or applicant to appear and show cause why similar disciplinary action or, in the case of an applicant, license denial or restriction, should not be imposed in this state. In any such proceeding, the decision of the foreign licensing authority may not be collaterally attacked, but the licensee or applicant shall be given the opportunity to demonstrate why a lesser sanction should be imposed. When acting under this paragraph, the board may issue any disciplinary sanction or take any action with regard to a license application, which would otherwise be permitted by this chapter, including sanctions or actions more stringent than those imposed by the foreign jurisdiction. The board shall adopt rules, pursuant to RSA 541-A, relative to handling summary proceedings brought under this paragraph, but shall furnish the respondent at least 10 days’ written notice and an opportunity to be heard.
V.(a) Every insurer, including self-insurers, providing professional liability insurance to a licensee of the board shall send a complete report to the board as to all reservable claims and suits coincident with the initiation of an action for dental injury within 30 days after the initiation of the action. For the purpose of this paragraph, dental injury means any adverse, untoward, or undesired consequences arising out of or sustained in the course of professional services rendered by a dental care provider, whether resulting from negligence, error, or omission in the performance of such services; from rendition of such services without informed consent or in breach of warranty or in violation of contract; from failure to diagnose; from premature abandonment of a patient or of a course of treatment; from failure properly to maintain equipment or appliances necessary to the rendition of such services; or otherwise arising out of or sustained in the course of such services.
(b) The board shall conduct an investigation of any person licensed by the board who has been the subject of 3 insurance claims or legal judgments for medical injury as defined in RSA 329:17, III, which pertain to 3 different events within any consecutive 5-year period.
317-B:20 Investigatory Powers of the Board; Complaints. In addition to powers granted under RSA 328-F:
I. The board may investigate possible misconduct by licensees and any other matters governed by the provisions of this chapter. Investigations may be conducted with or without the issuance of a board order setting forth the general scope of the investigation, and with or without prior notification to the licensee. An investigation may include unannounced inspections of the licensee’s practice location when deemed necessary to determine day-to-day practices or to prevent evidence from being hidden, altered, or destroyed. Board investigations and any information obtained by the board pursuant to such investigations shall be exempt from the public disclosure provisions of RSA 91-A, unless such information subsequently becomes the subject of a public disciplinary hearing. However, the board may disclose information obtained in an investigation to law enforcement or health licensing agencies in this state or any other jurisdiction, or in accordance with specific statutory requirements or court orders.
II. The board may retain legal counsel, dental advisors or other investigators to assist with any investigation and with adjudicatory hearings.
III. The board may commence a formal or informal investigation, or an adjudicative hearing, concerning allegations of misconduct and other matters within the scope of this chapter on its own motion whenever it has a reasonable basis for doing so, and the type of procedure chosen shall be a matter reserved to the discretion of the board. Investigations may be conducted on an ex parte basis.
IV.(a) The board may administer oaths or affirmations, preserve testimony, and issue subpoenas for witnesses and for documents during any formal investigation or adjudicatory hearing. The board may also subpoena patient records, as provided in paragraph V, during formal investigations.
(b) The board shall serve any subpoena not covered by paragraph V in accordance with the procedures and fee schedules established by the superior court, except that:
(1) Any person licensed by the board shall not be entitled to a witness fee or mileage expenses for travel within the state.
(2) The board shall not be required to tender witness fees and mileage expenses in advance if the subpoena is annotated “fees guaranteed by the New Hampshire board of dental hygiene.”
(3) The respondent shall be allowed at least 48 hours to comply with a subpoena issued under this chapter.
V. The board may at any time subpoena dental records from its licensees and patient records from hospitals, pharmacies, and other health care providers or facilities licensed by or certified in this state. Such subpoenas shall be served by certified mail or by personal delivery to the address shown on the licensee's current license, and no witness or other fee shall be required. A minimum of 15 days’ advance notice shall be allowed for complying with a subpoena duces tecum issued under this chapter.
VI. All licensees and any persons applying for licensure or any other privilege granted by the board shall have the duty to keep the board informed of their current business and residence addresses. Notice of any hearing or other action taken under this chapter shall be deemed adequate if notice is mailed to the most recent home or business address furnished to the board by the licensee, pursuant to RSA 317-B:17.
VII. Any complaint of licensee misconduct shall be in writing and shall be treated as a petition for the commencement of an adjudicatory hearing. The board shall fairly investigate all complaints to the extent and in the manner warranted by the allegations. Any complaint which fails to state a cause of action may be summarily denied in whole or in part. Some or all of the allegations in a complaint may be consolidated with another complaint or with issues which the board wishes to investigate or hear on its own motion. If an investigation of a complaint results in an offer of settlement by the licensee, the board may settle the allegations against the licensee without the consent of a complainant, provided that material facts are not in dispute and the complainant is given an opportunity to comment upon the terms of the proposed settlement.
VIII. At the commencement of an adjudicatory proceeding, or at any time during a formal or informal investigation, and without issuing a subpoena, the board may mail a statement of the issues being investigated or heard to any licensee or other person who is a proper subject of inquiry and require the licensee or other person to provide a detailed and good faith written response to the allegations identified by the board. The licensee or other person shall provide complete copies of office records concerning any patient whose treatment is relevant to the matters at issue. The licensee shall respond to such request within a reasonable time period of not less than 15 days, as the board may specify in its written request.
317-B:21 Hearings; Decisions; and Appeals.
I. Any adjudicatory hearing shall be an open public proceeding. Any member of the board may preside at such a hearing and may issue oaths or affirmations to witnesses.
II. The board shall furnish the licensee or any other respondent at least 15 days’ written notice of the date, time and place of a hearing, except as otherwise provided in this chapter. Such notice shall include an itemization of the issues to be heard, and, in the case of a disciplinary hearing, a statement as to whether the action has been initiated by a written complaint or upon the board’s own motion, or both. If a written complaint is involved, the complainant shall also receive a copy of the hearing notice and shall be provided with a reasonable opportunity to intervene as a party.
III. Any person appearing at a board hearing or investigation may be represented by legal counsel, but the board shall have no obligation or authority to appoint or provide an attorney to any person appearing at a board hearing or investigation.
IV. The board may at any time dispose of issues or allegations at an adjudicatory hearing, or an investigation, by default, settlement agreement, or consent order, by issuing an order of dismissal for failing to state a proper basis for disciplinary action. In adjudicatory or disciplinary hearings, the board may hold prehearing conferences which shall be exempt from the provisions of RSA 91-A, but all final disciplinary actions, including those which occur without holding a public hearing, shall be available to the public.
V. Adjudicatory decisions and final disciplinary actions of the board shall be made by a majority of the board members participating in the decision. Such decisions shall not be made public until they have been reduced to writing, signed by a representative of the board, and served upon the parties.
VI. Decisions of the board may be appealed to the supreme court pursuant to RSA 541. The court shall not stay any disciplinary sanction imposed by the board pending appeal, if the board has determined that the sanction is required for the public safety and welfare.
317-B:22 Temporary Suspension Where Imminent Threat. In cases involving imminent danger to life or health, the board shall order suspension of a license or privilege granted under this chapter pending hearing for a period of no more than 60 days. In such cases, the basis for the board’s finding of imminent danger to life or health shall be reduced to writing and combined with a hearing notice which complies with RSA 541-A:31, III. Notwithstanding the requirements of RSA 541-A:30, III, the board’s hearing may commence as much as 30 days after the date of the order suspending the license. If the board does not commence the hearing within 30 days, the suspension order shall be automatically vacated, but a licensee shall be allowed additional time to prepare for or to complete a hearing under this paragraph only by agreeing to a further suspension commensurate with the additional time extended.
2 Allied Health Professionals; Definition; Governing Board. Amend RSA 328-F:2, II to read as follows:
II. “Governing boards” means individual licensing boards of athletic trainers, occupational therapy assistants, occupational therapists, recreational therapists, physical therapists, physical therapist assistants, respiratory care practitioners, [and] speech-language pathologists, and dental hygienists.
3 New Paragraph; Allied Health Professionals; Dental Hygiene. Amend RSA 328-F:2 by inserting after paragraph IX the following new paragraph:
X. “Dental hygiene” means dental hygiene as defined in RSA 317-B:2.
4 Governing Board; Establishment. Amend RSA 328-F:3, I to read as follows:
I. There shall be established governing boards of athletic trainers, occupational therapists, recreational therapists, respiratory care practitioners, physical therapists, [and] speech-language pathologists, and dental hygienists.
5 New Paragraph; Dental Hygiene; Governing Board; Appointment. Amend RSA 328-F:4 by inserting after paragraph IX the following new paragraph:
X. The dental hygiene board shall consist of 3 licensed dental hygienists, one licensed dentist, and one public member.
6 Renewals; Dental Hygienists Added. Amend RSA 328-F:19, I to read as follows:
I. Initial licenses and renewals shall be valid for 2 years, except that timely and complete application for license renewal by eligible applicants shall continue the validity of the licenses being renewed until the governing board has acted on the renewal application. Licenses issued pursuant to RSA 328-A, RSA 326-G, and RSA 326-J shall expire in even-numbered years and licenses issued pursuant to RSA 326-C, RSA 326-E, [and] RSA 326-F, and RSA 317-B shall expire in odd-numbered years.
7 Dental Board; References to Hygienists Removed. Amend RSA 317-A:4, I to read as follows:
I. The board of dental examiners will have the following powers and duties:
(a) To examine, register, and license applicants whom it finds to be qualified as provided in this chapter to practice dentistry [and dental hygiene]. The public member of the board shall not examine applicants in the clinical practice of dentistry [or the clinical practice of dental hygiene];
(b) The dental hygiene members shall not examine applicants for the clinical practice of dentistry;
(c) To undertake, when appropriate, disciplinary proceedings and disciplinary action against licensees as authorized by RSA 317-A:17, 317-A:18, 317-A:18-a, 317-A:18-b, and any other appropriate disciplinary statutes;
(d) To obtain legal counsel, investigators, and such other assistance as may be required; to make contracts and arrangements for the performance of administrative and similar services; and to establish compensation therefor;
(e) To establish fees for examination of applicants for licenses and for renewal of licenses to practice dentistry [and dental hygiene] and for transcribing and transferring records and other services. The fees for dentists established by the board shall include not more than $30 of each application or renewal fee to be used for the funding of professional assistance programs or similar services as may be required under RSA 317-A:17, III(c). The fees established by the board shall be sufficient to provide revenues equal to 125 percent of the direct operating expenses of the board, including expenses under RSA 317-A:4, I(f), for the previous fiscal year;
(f) With the approval of the attorney general and the governor and council, to compensate the board’s counsel, investigators, and other assistants, appointed in connection with its activities under RSA 317-A:4, 317-A:17, 317-A:18, 317-A:18-a, and 317-A:18-b, on warrant of the governor out of any money in the treasury not otherwise appropriated; provided that any sums so expended shall be included in the computation of fees established for the subsequent fiscal year under RSA 317-A:4, I(e)[.];
(g) May request the state of New Hampshire director of dental health to serve as executive secretary to the board.
8 Dental Board; Licenses; References to Dental Hygiene Removed. Amend RSA 317-A:7 to read as follows:
317-A:7 License Required. No person shall begin the practice of dentistry[, or dental hygiene,] without first obtaining a license for such purpose from the board.
9 Dental Board; License by Endorsement; References to Dental Hygiene Removed. Amend RSA 317-A:7-a to read as follows:
317-A:7-a License by Endorsement. Licensure by endorsement may be considered by the board for each applicant who holds a current, unrestricted license and registration certificate to practice dentistry [or dental hygiene] and who submits to the board the required credentials if, for the 3 years immediately preceding the application, the applicant:
I. Has practiced clinical dentistry [or practiced clinical dental hygiene] in one or more states; or
II. Has been in dental specialty training; or
III. Has been in active military service as a dentist; or
IV. Has been in any combination of these.
10 Dental Board; Applications; References to Dental Hygiene Removed. Amend RSA 317-A:8, IV to read as follows:
IV. A temporary license may be issued, at the discretion of the board, to dentists [and dental hygienists] for the provision of voluntary dental [or dental hygiene services]. To qualify for licensure under this paragraph, the applicant shall be an active, inactive, or former licensee in New Hampshire or in another state or Canadian province as determined by the board.
11 Dental Board; Applications; References to Dental Hygiene Removed. Amend RSA 317-A:9 to read as follows:
317-A:9 Examinations. Applicants for a license to practice dentistry [or dental hygiene] shall be examined by the board or have successfully passed a national or regional test accepted by the board. Examinations may be oral, clinical, written, or any combination at the discretion of the board and shall be of such character as to test the qualifications of the applicant to practice dentistry [or dental hygiene]. No license shall be granted to any applicant who shall not pass such examination.
12 Dental Board; Rulemaking. Amend RSA 317-A:12, I to read as follows:
I. The application procedure for a dental [or dental hygiene] license;
13 Dental Board; Rulemaking. Amend RSA 317-A:12, VI to read as follows:
VI. Ethical standards required to be met by each holder of a dental [or dental hygiene] license and how such licenses may be revoked for violation of these standards;
14 Dental Board; Renewal. Amend RSA 317-A:13 to read as follows:
317-A:13 License Renewal.
I.(a) By February 15 in each even-numbered year, the board shall mail to each person licensed to practice dentistry a notice of registration and license renewal form.
(b) [By February 15 in each odd-numbered year, the board shall mail to each person licensed to practice dental hygiene a notice of registration and license renewal form.
(c)] A failure of the licensee to receive the license renewal form shall not relieve the licensee of the obligation to comply with this section and the rules of the board.
II. Except as provided in RSA 317-A:16, before April 1 in the year of renewal under paragraph I a person licensed to practice dentistry [or dental hygiene] in this state shall register with the board, apply for license renewal, and pay the fee established in rules adopted by the board. The timelines of submission of renewal applications shall be evidenced by date stamp or other record made at the time of receipt at the board’s office.
III. All persons licensed to practice dentistry [or dental hygiene] in this state shall notify the board in writing within 10 days of any change of business or residential address which may occur during the period between biennial registrations.
15 Dental Board; Inactive List. Amend RSA 317-A:16 to read as follows:
317-A:16 Inactive List. A dentist [or dental hygienist] licensed under this chapter who does not actively engage in such practice in New Hampshire within 2 years of his or her previous biennial registration shall have the licensee’s name transferred to an inactive list and shall be required to register biennially and pay the inactive registration fee as long as the licensee remains inactive. Any dentist [or dental hygienist] holding an inactive license shall be restored to active status by the board upon the filing of a written request with the board and the furnishing of evidence of continuing professional character and competence and upon payment of the full registration fee established in rules adopted by the board. A person’s right to maintain a license with active status shall not be affected by any absence from active practice in New Hampshire while serving on active duty in the armed forces of the United States.
16 Dental Board; Misconduct; References to Dental Hygiene Removed. Amend RSA 317-A:17, II(c)-(f) to read as follows:
(c) Affliction with a physical or mental impairment or disease which is dangerous to the public health or which precludes the practice of dentistry [or dental hygiene] at ordinary levels of proficiency.
(d) Ignorance, incompetence, or a pattern of behavior inconsistent with the basic knowledge and skills expected of persons licensed to practice dentistry [or dental hygiene].
(e) Gross or repeated negligence in practicing dentistry [or dental hygiene].
(f) Intentionally injuring a patient or engaging in any other unprofessional or dishonest conduct in practicing dentistry [or dental hygiene].
17 Dental Board; Applicants; References Removed. Amend RSA 317-A:24 and 25 to read as follows:
317-A:24 Applicants From Other States. The board may license any applicant for a dental [or dental hygienist] license who is so licensed in any other state, provided the other state’s licensing requirements are substantially equivalent to or higher than those of this state.
317-A:25 Certificate of Good Standing. Any one who is licensed to practice dentistry [or dental hygiene] in this state, and of good professional character, and known to the dental board as such, who desires to change residence to another state, territory, or country, shall, upon application to the dental board, receive a special certificate over the signature of the president and vice-president of the board, which shall attest such facts, and give the date upon which such person was licensed.
18 Dental Board; Records; Penalties; References Removed. Amend RSA 317-A:27-a through RSA 317-A:29 to read as follows:
317-A:27-a Dental Records. Dentists [and dental hygienists] shall make a record of all examinations and treatments performed or recommended. The record shall be in such a manner and in sufficient detail that it may be used for identification purposes. A dentist shall maintain patients’ paper, electronic, and radiographic records for at least 7 years from the time the dentist [or dental hygienist] last treated the patient. In the case of a minor patient, a dentist shall maintain a patient’s paper, electronic, and radiographic dental records for at least 7 years past the age of majority.
19 List of Dentists. Amend RSA 317-A:29 to read as follows:
317-A:29 List of Dentists [and Dental Hygienists]. Any manager, proprietor, partnership, association, or corporation specified in RSA 317-A:28 shall, within 10 days after demand made by the vice-president of the board by registered mail, furnish to the vice-president the names and addresses of all persons practicing dentistry [or dental hygiene] in their or its place of business or under their or its control, together with a sworn statement showing by what license or authority said persons are practicing.
20 Dental Board; Penalty; Reference to Dental Hygiene Removed. Amend RSA 317-A:33 to read as follows:
317-A:33 Penalty. Except as otherwise provided, any person who shall practice or attempt to practice dentistry [or dental hygiene] in this state without a license or who violates any of the provisions of RSA 317-A shall be guilty of a misdemeanor if a natural person or guilty of a felony if any other person.
21 Repeal. The following are repealed:
I. RSA 317-A:20, IV, relative to dental hygiene.
II. RSA 317-A:21 through RSA 317-A:21-d, relative to regulation of dental hygienists by the dental board.
22 Applicability; Licenses; Rules.
I. Any license to practice as a dental hygienist issued by the board of dental examiners under RSA 317-A and which is current on June 30, 2011 shall continue to have effect and be recognized by the board of dental hygiene established in this act according to the terms of the license, provided the licensee complies with the remaining provisions of RSA 317-B on and after the effective date of this act.
II. Any rule adopted by the board of dental examiners under RSA 317-A relating to the regulation of dental hygienists shall continue to be effective and apply to licensed dental hygienists until such rule is superseded or readopted according to the provisions of RSA 317-B:7, RSA 328-F, and RSA 541-A by the board of dental hygiene established in RSA 317-B as inserted by this act.
23 Effective Date. This act shall take effect July 1, 2011.
LBAO
11-0230
Revised 02/09/11
HB 452 FISCAL NOTE
AN ACT establishing the independent regulation of dental hygienists.
FISCAL IMPACT:
The Board of Allied Health Professionals and Board of Dental Examiners state this bill will increase state general fund expenditures by $40,456 in FY 2012, $37,086 in FY 2013, $37,816 in FY 2014, and $38,509 in FY 2015 and will decrease state general fund revenues by $85,085 in FY 2013 and by $94,435 FY 2015. There will be no impact on county and local revenues or expenditures.
METHODOLOGY:
The Board of Allied Health Professionals and Board of Dental Examiners state this bill establishes a governing board of dental hygiene under the Board of Allied Health Professionals and removes provisions for dental hygienist regulation from the Board of Dental Examiners. The Board of Allied Health Professionals states under this bill, the new Board of Dental Hygienists, with 1,462 licensees and approximately 85 new licensees a year, would require one full-time license clerk. The Board anticipates one full-time license clerk currently working for the Board of Dental Examiners would be transferred to the Board of Allied Health Professionals, and the Board of Dental Examiners would hire a part-time clerk replacement. The Board of Allied Health Professionals also states it would need to move to accommodate the new personnel and related desk furniture and file cabinets. Under this bill, members of the Board of Dental Hygiene would be compensated $100 for attendance at a regular board meeting and $50 for each day engaged in official duties of the Board. The Board estimates increased expenditures as follows:
FY 2012 |
FY 2013 |
FY 2014 |
FY 2015 | |
Full-time License Clerk Salary (LG 11 @ Step 8) |
34,668 |
33,384 |
33,384 |
33,384 |
Social Security (@ 6.2%) |
2,070 |
2,070 |
2,070 |
2,070 |
Medicare (@ 1.45%) |
484 |
484 |
484 |
484 |
Retirement |
4,110 |
4,110 |
4,110 |
4,110 |
Life Insurance |
20 |
20 |
20 |
20 |
Dental |
937 |
984 |
1,033 |
1,085 |
Health |
14,709 |
16,582 |
18,030 |
19,962 |
Full-Time Clerk Subtotal |
56,998 |
57,634 |
59,131 |
61,115 |
Current Expenses (cost to write and distribute new rules in FY 2012, telephone, other expenses) |
3,333 |
1,833 |
1,833 |
1,833 |
Moving Expenses, Increased Rent |
3,000 |
3,000 |
3,000 |
3,000 |
Transfer of database and licensing software |
1,000 |
1,000 |
1,000 |
1,000 |
Equipment (computer, desk, chair, file cabinets) |
3,000 |
500 |
500 |
500 |
Consultants (reserve for expert witnesses in case of disciplinary proceedings) |
1,000 |
1,000 |
1,000 |
1,000 |
Transfers to other agencies (DHHS for personnel, Dept of Justice) |
7,481 |
7,481 |
7,481 |
7,481 |
Board Members (mileage and increased reimbursement for duties) |
7,000 |
7,000 |
7,000 |
7,000 |
Total |
82,812 |
79,448 |
80,945 |
82,929 |
The Board of Dental Examiners states it would no longer require the services of a full-time license clerk under this bill, but would need a part-time clerk. The Board estimates a reduction in expenditures of approximately $2,500 for office supplies and expenses in FY 2012 and each year thereafter. Other Board functions such as dental office inspections, anesthesia/sedation evaluation, and adjudicatory proceedings largely involve dentists and dental practices and would not be affected by this bill. The Board estimates changes in expenditures as follows:
FY 2012 |
FY 2013 |
FY 2014 |
FY 2015 | |
Part-Time Clerk (LG 12 @ 60 percent FTE) |
15,924 |
16,509 |
17,187 |
17,831 |
Benefits (Social Security @ 6.2% and Medicare @ 1.45%) |
1,218 |
1,263 |
1,315 |
1,364 |
Park-Time Clerk Subtotal |
17,142 |
17,772 |
18,502 |
19,195 |
Reduction In Full-Time Clerk Salary and Benefits |
(56,998) |
(57,634) |
(59,131) |
(61,115) |
Current Expenses |
(2,500) |
(2,500) |
(2,500) |
(2,500) |
Total |
(42,356) |
(42,362) |
(43,129) |
(44,420) |
The net change in state restricted expenditures is estimated as follows:
FY 2012 |
FY 2013 |
FY 2014 |
FY 2015 | |
Change In Board of Allied Health Professionals Expenditures |
82,812 |
79,448 |
80,945 |
82,929 |
Change In Board of Dental Examiners Expenditures |
(42,356) |
(42,362) |
(43,129) |
(44,420) |
Net Change |
40,456 |
37,086 |
37,816 |
38,509 |
The Board of Dental Examiners fee to renew a license is $165 while the Board of Allied Health fee to renew a license is $110. The 1,462 dental hygienists currently licensed in the state are required to renew in odd numbered years. Additionally, the Board of Dental Examiners and Board of Allied Health Professionals both charge $110 for an initial license for approximately 85 new licensees per year. The Board of Allied Health Professionals and Board of Dental Examiners anticipate revenues will change as follows:
FY 2012 |
FY 2013 |
FY 2014 |
FY 2015 | |
Number of New Licensees |
85 |
85 |
85 |
85 |
New Licensee Revenue For Dental Hygiene |
9,350 |
9,350 |
9,350 |
9,350 |
New Licensee Revenue For Dental Examiners |
(9,350) |
(9,350) |
(9,350) |
(9,350) |
Number of Renewing Licensees |
1,462 |
1,547 |
1,632 |
1,717 |
Renewing Licensee Revenue For Dental Hygiene |
170,170 |
188,870 | ||
Renewing Licensee Revenue For Dental Examiners |
(255,255) |
(283,305) |
Both the Board of Allied Health Professionals and the Board of Dental Examiners state they will need to increase fees to meet the statutory requirement to raise 125 percent of expenditures. The Boards estimate net change in state restricted revenues as follows:
FY 2012 |
FY 2013 |
FY 2014 |
FY 2015 | |
Change In Board of Dental Examiners Revenues |
(9,350) |
(264,605) |
(9,350) |
(292,655) |
Change In Board of Allied Health Professionals Revenues |
9,350 |
179,520 |
9,350 |
198,220 |
Net Change |
0 |
(85,085) |
0 |
(94,435) |