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A45, R107, H4007
Sponsors: Rep. Bingham
Document Path: l:\council\bills\nbd\11605ac03.doc
Companion/Similar bill(s): 663
Introduced in the House on April 16, 2003
Introduced in the Senate on May 21, 2003
Last Amended on May 20, 2003
Passed by the General Assembly on May 23, 2003
Governor's Action: June 2, 2003, Signed
Summary: Dental hygienists
HISTORY OF LEGISLATIVE ACTIONS
Date Body Action Description with journal page number ------------------------------------------------------------------------------- 4/16/2003 House Introduced and read first time HJ-3 4/16/2003 House Referred to Committee on Medical, Military, Public and Municipal Affairs HJ-4 5/14/2003 House Committee report: Favorable with amendment Medical, Military, Public and Municipal Affairs HJ-34 5/15/2003 Scrivener's error corrected 5/20/2003 House Amended HJ-20 5/20/2003 House Read second time HJ-21 5/21/2003 House Read third time and sent to Senate HJ-14 5/21/2003 Scrivener's error corrected 5/21/2003 Senate Introduced, read first time, placed on calendar without reference SJ-6 5/22/2003 Senate Read second time SJ-24 5/22/2003 Senate Unanimous consent for third reading on next legislative day SJ-24 5/23/2003 Senate Read third time and enrolled SJ-8 5/28/2003 Ratified R 107 6/2/2003 Signed By Governor 6/5/2003 Copies available 6/5/2003 Effective date 06/02/03 6/19/2003 Act No. 45
View the latest legislative information at the LPITS web site
VERSIONS OF THIS BILL
(A45, R107, H4007)
AN ACT TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 40-15-82 SO AS TO SPECIFY CERTAIN FUNCTIONS AND PROCEDURES THAT MAY NOT BE DELEGATED TO DENTAL HYGIENISTS; TO AMEND SECTION 40-15-85, AS AMENDED, RELATING TO DEFINITIONS OF TERMS USED IN THE LICENSURE AND REGULATION OF DENTISTS AND DENTAL HYGIENISTS, SO AS TO REVISE THE DEFINITION OF "GENERAL SUPERVISION" AND "ORAL PROPHYLAXIS"; BY ADDING SECTION 40-15-102 SO AS TO SPECIFY CERTAIN FUNCTIONS THAT A DENTAL HYGIENIST MAY ONLY PERFORM UNDER GENERAL SUPERVISION IN A PRIVATE OFFICE SETTING; AND TO AMEND SECTION 40-15-110, RELATING TO CERTAIN EXEMPTIONS FROM THE REQUIREMENTS OF CHAPTER 15, TITLE 40 REGULATING DENTISTS AND DENTAL HYGIENISTS, SO AS TO REVISE PROVISIONS PERTAINING TO DENTAL HYGIENISTS PROVIDING SERVICES IN A PUBLIC HEALTH SETTING.
Be it enacted by the General Assembly of the State of South Carolina:
Functions that may not be delegated
SECTION 1. Chapter 15, Title 40 of the 1976 Code is amended by adding:
"Section 40-15-82. The following functions and procedures must not be delegated to dental hygienists:
(1) dental examinations, dental diagnoses, and dental treatment planning;
(2) cutting or performing surgical procedures on hard and soft tissues;
(3) performing restorative, prosthetic, and orthodontic procedures and other procedures that require professional education and skill of the dentist;
(4) performing any intra-oral procedure that would affect the function or efficiency of an appliance which, when worn by the patient, would come in direct contact with hard or soft tissue;
(5) placing and carving permanent type restorations in or on teeth;
(6) making impressions and jaw relation records, other than study casts and opposing casts, that will be issued for construction of dental appliances, other than bleaching trays;
(7) making any and all corrections of malformation of teeth or the jaws;
(8) making decisions concerning drugs and their dosages and writing prescriptions or work authorizations, except pursuant to standing orders;
(9) administering general anesthesia or nitrous oxide analgesia;
(10) administering local anesthesia other than under direct supervision."
SECTION 2. Section 40-15-85 of the 1976 Code, as amended by Act 298 of 2000, is further amended to read:
"Section 40-15-85. For purposes of this chapter:
(1) 'Direct supervision' means that a dentist is in the dental office, personally diagnoses the condition to be treated, personally authorizes the procedure, and before the dismissal of the patient, evaluates the performance of the auxiliary. This requirement does not mandate that a dentist be present at all times, but he or she must be on the premises actually involved in supervision and control.
(2) 'General supervision' means that a licensed dentist or the South Carolina Department of Health and Environmental Control's public health dentist has authorized the procedures to be performed but does not require that a dentist be present when the procedures are performed.
(3) 'Oral prophylaxis' means the removal of any and all hard and soft deposits, accretions, toxins, and stain from any natural or restored surfaces of teeth or prosthetic devices by scaling and polishing as a preventive measure for the control of local irritational factors."
Functions authorized under general supervision in a private office setting
SECTION 3. Chapter 15, Title 40 of the 1976 Code is amended by adding:
"Section 40-15-102. (A) 'Authorized' means the supervising dentist in a private office setting has personally approved the procedures to be performed and is responsible for the care provided to the patient.
(B) In a private dental office setting, a dental hygienist may only perform the following functions under general supervision:
(1) oral prophylaxis and assessment;
(2) fluoride treatment;
(3) oral hygiene instruction and education;
(4) exposure and process of radiographs as directed by standard office protocol.
(C) A dentist in a private office setting may authorize general supervision only upon meeting the following criteria:
(1) a new patient of record must be clinically examined by the authorizing dentist during the initial visit;
(2) an appointed patient must be examined by the authorizing dentist at a minimum of twelve-month intervals.
(3) an appointed patient must be notified in advance of the appointment that he or she will be treated by the dental hygienist under general supervision without the authorizing dentist being present or being examined by the authorizing dentist.
(D) A dentist authorizing treatment by a dental hygienist in school settings or nursing home settings is subject to the general supervision restrictions provided for in this section unless the dentist or dental hygienist is working in a public health setting with the Department of Health and Environmental Control, as provided for in Section 40-15-110.
(E) A dentist billing for services for treatment provided by a dental hygienist in a public health setting with the Department of Health and Environmental Control as provided for in Section 40-15-110, is the provider of services and is clinically responsible for the care and treatment of the patient."
Further regulations and exemptions
SECTION 4. Section 40-15-110 of the 1976 Code is amended to read:
"Section 40-15-110. (A) Nothing in this chapter may be construed to prevent:
(1) the practice of medicine by a licensed physician or the administration of anesthesia by those persons qualified by law to do so;
(2) the performance of official duties by commissioned dental or medical officers of the United States Army, Navy, Air Force, Veterans' Administration, or United States Public Health Service;
(3) a person from teaching or demonstrating dentistry or related procedures at a dental society meeting or at a dental convention or at an accredited dental college;
(4) a licensed dentist of another state or country from performing duties in connection with a specific case for which he is called into the State by a dentist licensed in this State;
(5) dental students from performing dental procedures under the supervision of instructors in any dental school in this State accredited by the commission;
(6) licensed dental hygienists or registered dental technicians from teaching in programs accredited by the Commission;
(7) a person from making roentgenograms or X-ray exposures under the supervision of a licensed dentist or prevents persons licensed to practice dental hygiene from performing an intra-oral dental hygiene procedure if it is performed under the direction and control of a licensed dentist present on the premises;
(8) a person from performing dental or orthodontic technological work if:
(a) the intra-oral procedures relative to such work are performed by a licensed dentist;
(b) the work is performed by or under the direction and control of a licensed dentist on his premises, or by or under the direction and control of a registered dental or orthodontic technician present on the premises; however, orthodontic work performed under the direction and control of a registered orthodontic technician is limited to orthodontic technological work; and
(c) the work is performed pursuant to a properly executed work authorization, as provided for in this chapter, if the work is to be done by or under the direction and control of a registered dental or orthodontic technician.
(9) a certified or qualified dental assistant or licensed dental hygienist from taking impressions for dental study casts under the direct supervision of a licensed dentist present on the premises;
(10) a licensed dental hygienist employed within or contracted through the public health system from providing education and primary preventive care that is reversible. Primary preventive care and education are defined as promotion and protection of health to avoid the occurrence of disease through community, school, and individual measures or improvements in lifestyle. These services are to be performed under the direction of the Department of Health and Environmental Control State Dental Coordinator or the department's designee but do not require that the director or a licensed dentist be present when any public health dental program services are provided. Public health dental program services include oral screenings using a Department of Health and Environmental Control approved screening system, oral prophylaxis, application of topical fluoride including varnish, and the application of dental sealants.
(B) A dentist licensed in another state teaching in a dental college in this State accredited by the commission is exempt from the licensure requirement unless he engages in the intramural or private practice of dentistry.
(C) Nothing in this chapter may be construed to require licensure for interns or residents enrolled in an intern or residency training program approved by the commission.
(D) Unlicensed personnel in a dental office may perform those tasks as authorized by the board and for which minimal training standards and qualifications are established by regulation. All tasks permitted to be performed by other than licensed personnel must be under the direct supervision of a dentist present on the premises and licensed in this State.
(E) The Department of Health and Environmental Control shall target services in a public health setting to under-served populations. A public health setting is defined as a hospital, nursing home, long term care facility, rural or community health clinic, health facility operated by federal, state, county, or local governments, hospice, an educational institution, a bona fide charitable institution, or a mobile delivery program operated in one of these settings under the direction of the Department of Health and Environmental Control. Mobile delivery programs are defined as those that are not confined to a single building and can be transported from place to place.
(F) Dental assistants may perform oral screenings utilizing the Department of Health and Environmental Control approved screening system in school and public health settings under direction of the Department of Health and Environmental Control public health dental program.
(G) Dental assistants employed within or contracted through the public health system may assist in the delivery of public health dental program services as defined in this section. Program activities are performed under the direction of the Department of Health and Environmental Control State Dental Coordinator or the department's designee but do not require that the coordinator be present when services are performed.
(H) Licensed dental hygienists and dental assistants within the public health system may perform other duties authorized by regulations of the State Board of Dentistry."
SECTION 5. This act takes effect upon approval by the Governor.
Ratified the 28th day of May, 2003.
Approved the 2nd day of June, 2003.
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