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  By: Schwertner, et al.  S.B. No. 313
         (In the Senate - Filed March 6, 2017; March 7, 2017, read
  first time and referred to Committee on Health & Human Services;
  April 3, 2017, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 9, Nays 0; April 3, 2017,
  sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 313 By:  Schwertner
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to the continuation and functions of the State Board of
  Dental Examiners; imposing fees.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 251.005, Occupations Code, is amended to
  read as follows:
         Sec. 251.005.  APPLICATION OF SUNSET ACT.  The State Board of
  Dental Examiners is subject to Chapter 325, Government Code (Texas
  Sunset Act).  Unless continued in existence as provided by that
  chapter, the board is abolished September 1, 2029 [2017].
         SECTION 2.  Section 252.001(a), Occupations Code, is amended
  to read as follows:
         (a)  The State Board of Dental Examiners consists of 11 [15]
  members appointed by the governor with the advice and consent of the
  senate as follows:
               (1)  six [eight] reputable dentist members who reside
  in this state and have been actively engaged in the practice of
  dentistry for at least the five years preceding appointment;
               (2)  three [two] reputable dental hygienist members who
  reside in this state and have been actively engaged in the practice
  of dental hygiene for at least the five years preceding
  appointment; and
               (3)  two [five] members who represent the public.
         SECTION 3.  Section 252.003, Occupations Code, is amended to
  read as follows:
         Sec. 252.003.  MEMBERSHIP AND EMPLOYEE RESTRICTIONS.
  (a)  In this section, "Texas trade association" means a
  [nonprofit,] cooperative[,] and voluntarily joined statewide
  association of business or professional competitors in this state
  designed to assist its members and its industry or profession in
  dealing with mutual business or professional problems and in
  promoting their common interest.
         (b)  A person may not be a member of the board and may not be a
  board employee employed in a "bona fide executive, administrative,
  or professional capacity," as that phrase is used for purposes of
  establishing an exemption to the overtime provisions of the federal
  Fair Labor Standards Act of 1938 (29 U.S.C. Section 201 et seq.) if:
               (1)  the person is an [An] officer, employee, or paid
  consultant of a Texas trade association in the field of health care;
  or
               (2)  the person's [may not be a member or employee of
  the board who is exempt from the state's position classification
  plan or is compensated at or above the amount prescribed by the
  General Appropriations Act for B9 of the position classification
  salary schedule.
         [(c)  A person who is the] spouse is [of] an officer,
  manager, or paid consultant of a Texas trade association in the
  field of health care [may not be a board member and may not be a
  board employee who is exempt from the state's position
  classification plan or is compensated at or above the amount
  prescribed by the General Appropriations Act for B9 of the position
  classification salary schedule].
         (c) [(d)]  A person may not serve as a member of the board or
  act as the general counsel to the board if the person is required to
  register as a lobbyist under Chapter 305, Government Code, because
  of the person's activities for compensation on behalf of a
  profession related to the operation of the board.
         SECTION 4.  Section 252.010, Occupations Code, is amended by
  amending Subsection (b) and adding Subsection (d) to read as
  follows:
         (b)  The training program must provide the person with
  information regarding:
               (1)  the law governing board operations [this
  subtitle];
               (2)  the programs, [operated by the board;
               [(3)  the role and] functions, [of the board;
               [(4)  the] rules, and [of the board, with an emphasis on
  the rules that relate to disciplinary and investigatory authority;
               [(5)  the current] budget of [for] the board;
               (3)  the scope of and limitations on the rulemaking
  authority of the board;
               (4) [(6)]  the results of the most recent formal audit
  of the board;
               (5) [(7)]  the requirements of:
                     (A)  laws relating to [the] open meetings [law],
  [Chapter 551, Government Code;
                     [(B)  the] public information [law], [Chapter
  552, Government Code;
                     [(C)  the] administrative procedure [law],
  [Chapter 2001, Government Code;] and disclosing conflicts
                     [(D)     other laws relating to public officials,
  including conflict] of interest [laws]; and
                     (B)  other laws applicable to members of the board
  in performing their duties; and
               (6) [(8)]  any applicable ethics policies adopted by
  the board or the Texas Ethics Commission.
         (d)  The executive director shall create a training manual
  that includes the information required by Subsection (b). The
  executive director shall distribute a copy of the training manual
  annually to each board member. On receipt of the training manual,
  each board member shall sign and submit to the executive director a
  statement acknowledging receipt of the training manual.
         SECTION 5.  Chapter 254, Occupations Code, is amended by
  adding Section 254.0065 to read as follows:
         Sec. 254.0065.  CONFIDENTIALITY OF CERTAIN INFORMATION
  REGARDING APPLICANT OR LICENSE HOLDER.  (a)  In this section,
  "license" has the meaning assigned by Section 263.0001.
         (b)  Except as provided by Subsection (c), all information,
  records, and proceedings of the board or an authorized agent of the
  board relating to the participation of an applicant for or holder of
  a license in a peer assistance program or the evaluation of an
  applicant or license holder under Section 263.0025 are confidential
  and not subject to disclosure under Chapter 552, Government Code.
         (c)  The board may disclose a disciplinary action taken
  against a license holder in the enforcement of Section
  263.002(a)(1), (7), or (11). The board may not disclose the nature
  of the impairment or condition that resulted in the board's action.
         SECTION 6.  Section 254.010(b), Occupations Code, is amended
  to read as follows:
         (b)  Rules adopted under this section must include
  procedures to:
               (1)  monitor for compliance a license holder who is
  ordered by the board to perform a certain act; [and]
               (2)  identify and monitor each license holder who
  represents a risk to the public; and
               (3)  periodically review reports filed with the
  National Practitioner Data Bank for any report of disciplinary
  action taken against a license holder by another state that would
  constitute grounds for disciplinary action under Section 263.002.
         SECTION 7.  Chapter 254, Occupations Code, is amended by
  adding Section 254.0105 to read as follows:
         Sec. 254.0105.  MONITORING HARMFUL PRESCRIBING PATTERNS.
  (a)  The board shall periodically check the prescribing
  information submitted to the Texas State Board of Pharmacy as
  authorized by Section 481.076(a)(1), Health and Safety Code, to
  determine whether a dentist licensed under this subtitle is
  engaging in potentially harmful prescribing patterns or practices.
         (b)  The board, in coordination with the Texas State Board of
  Pharmacy, shall determine the conduct that constitutes a
  potentially harmful prescribing pattern or practice for purposes of
  Subsection (a). In determining the conduct that constitutes a
  potentially harmful prescribing pattern or practice, the board
  shall consider:
               (1)  the number of times a dentist licensed under this
  subtitle prescribes a drug listed in Section 258.0535(b); and
               (2)  for prescriptions described by Subdivision (1),
  patterns of prescribing combinations of those drugs and other
  dangerous combinations of drugs identified by the board.
         (c)  If the board suspects that a dentist licensed under this
  subtitle may be engaging in potentially harmful prescribing
  patterns or practices, the board may notify the dentist of the
  potentially harmful prescribing pattern or practice.
         (d)  The board may initiate a complaint against a dentist
  based on information obtained under this section.
         SECTION 8.  Chapter 255, Occupations Code, is amended by
  adding Section 255.0055 to read as follows:
         Sec. 255.0055.  REQUIREMENTS FOR CERTAIN COMPLAINTS.
  (a)  In this section:
               (1)  "Anonymous complaint" means a complaint that lacks
  sufficient information to identify the source or the name of the
  person who filed the complaint.
               (2)  "Insurance agent" means a person licensed under
  Chapter 4054, Insurance Code.
               (3)  "Insurer" means an insurance company or other
  entity authorized to engage in the business of insurance under
  Subtitle C, Title 6, Insurance Code.
               (4)  "Third-party administrator" means a person
  required to have a certificate of authority under Chapter 4151,
  Insurance Code.
         (b)  The board may not accept anonymous complaints.
         (c)  Notwithstanding any confidentiality requirements under
  Chapter 552, Government Code, or this subtitle, a complaint filed
  with the board by an insurance agent, insurer, pharmaceutical
  company, or third-party administrator against a license holder must
  include the name and address of the insurance agent, insurer,
  pharmaceutical company, or third-party administrator filing the
  complaint.  Not later than the 15th day after the date the complaint
  is filed with the board, the board shall notify the license holder
  who is the subject of the complaint of the name and address of the
  insurance agent, insurer, pharmaceutical company, or third-party
  administrator who filed the complaint, unless the notice would
  jeopardize an investigation.
         SECTION 9.  Section 255.006(a), Occupations Code, is amended
  to read as follows:
         (a)  A complaint received under this chapter must be filed
  with and reviewed by the board to determine jurisdiction.  If the
  board has jurisdiction, the board shall complete a preliminary
  investigation of the complaint not later than the 60th day after the
  date of receiving the complaint.  The board shall first determine
  whether the person regulated under this subtitle who is the subject
  of the complaint [license holder] constitutes a continuing threat
  to the public welfare.  On completion of the preliminary
  investigation, the board shall determine whether to officially
  proceed on the complaint.  If the board fails to complete the
  preliminary investigation in the time required by this subsection,
  the board's official investigation of the complaint is considered
  to commence on that date.
         SECTION 10.  Section 256.002(a), Occupations Code, is
  amended to read as follows:
         (a)  An applicant for a license to practice dentistry must:
               (1)  be at least 21 years of age; and
               (2)  [be of good moral character; and
               [(3)]  present proof of:
                     (A)  graduation from a dental school accredited by
  the Commission on Dental Accreditation of the American Dental
  Association; or
                     (B)  graduation from a dental school that is not
  accredited by the commission and successful completion of training
  in an American Dental Association approved specialty in an
  education program accredited by the commission that consists of at
  least two years of training as specified by the Council on Dental
  Education.
         SECTION 11.  Section 256.053, Occupations Code, is amended
  to read as follows:
         Sec. 256.053.  ELIGIBILITY FOR LICENSE.  (a)  An applicant
  for a license to practice dental hygiene in this state must be:
               (1)  at least 18 years of age;
               (2)  [of good moral character;
               [(3)]  a graduate of an accredited high school or hold a
  certificate of high school equivalency; and
               (3) [(4)]  a graduate of a recognized school of
  dentistry or dental hygiene accredited by the Commission on Dental
  Accreditation of the American Dental Association and approved by
  the board or an alternative dental hygiene training program.
         (b)  A school of dentistry or dental hygiene described by
  Subsection (a)(3) [(a)(4)] must include at least two full academic
  years of instruction or its equivalent at the postsecondary level.
         SECTION 12.  The heading to Section 256.103, Occupations
  Code, is amended to read as follows:
         Sec. 256.103.  DISPLAY OF [ANNUAL] REGISTRATION
  CERTIFICATE.
         SECTION 13.  The heading to Section 257.001, Occupations
  Code, is amended to read as follows:
         Sec. 257.001.  LICENSE EXPIRATION; TERM.
         SECTION 14.  Section 257.001, Occupations Code, is amended
  by amending Subsections (a) and (c) and adding Subsection (a-1) to
  read as follows:
         (a)  A license issued under this subtitle is valid for a term
  of one or two years, as determined by board rule.
         (a-1)  The board by rule may adopt a system under which
  licenses expire on various dates during the year.
         (c)  For the year in which the expiration date is changed,
  license fees payable [on or before March 1] shall be prorated on a
  monthly basis so that each license holder pays only that portion of
  the fee that is allocable to the number of months during which the
  license is valid. On renewal of the license on the new expiration
  date, the total license fee is payable.
         SECTION 15.  Sections 257.002(a) and (f), Occupations Code,
  are amended to read as follows:
         (a)  A person required to hold a license as a practitioner
  under this subtitle who fails or refuses to apply for renewal of a
  license and pay the required fee on or before the specified date [of
  each calendar year] is:
               (1)  suspended from practice; and
               (2)  subject to the penalties imposed by law on any
  person unlawfully engaging in a practice regulated under this
  subtitle.
         (f)  The requirements prescribed by this section relating to
  the payment of [annual] license fees and penalties for the failure
  to timely renew a license do not apply to license holders who are on
  active duty with the armed forces of the United States and are not
  engaged in private or civilian practice.
         SECTION 16.  Chapter 257, Occupations Code, is amended by
  adding Section 257.003 to read as follows:
         Sec. 257.003.  REFUSAL FOR VIOLATION OF BOARD ORDER. The
  board may refuse to renew a license issued under this subtitle if
  the license holder is in violation of a board order.
         SECTION 17.  Section 257.004(c), Occupations Code, is
  amended to read as follows:
         (c)  A dentist or dental hygienist licensed by the board who
  resides in a country other than the United States on the renewal
  date of the person's license and has not practiced dentistry or
  dental hygiene in the United States during the license period
  [year] preceding the renewal date is exempt from the requirements
  of Subsection (a) if the person submits proof of foreign residence
  with the person's renewal application.
         SECTION 18.  Section 257.005(a), Occupations Code, is
  amended to read as follows:
         (a)  The board shall develop a mandatory continuing
  education program for licensed dentists and dental hygienists. The
  board by rule shall establish the minimum number of [require a
  license holder to complete at least 12] hours of continuing
  education a license holder is required to complete for each
  [annual] registration period to renew the license for a subsequent
  registration [annual] period.
         SECTION 19.  Section 258.002(a), Occupations Code, is
  amended to read as follows:
         (a)  A licensed dentist may delegate to a qualified and
  trained dental assistant acting under the dentist's general or
  direct supervision any dental act that a reasonable and prudent
  dentist would find is within the scope of sound dental judgment to
  delegate if:
               (1)  in the opinion of the delegating dentist, the act:
                     (A)  can be properly and safely performed by the
  person to whom the dental act is delegated; and
                     (B)  is performed in a customary manner and is not
  in violation of this subtitle or any other statute;
               (2)  the person to whom the dental act is delegated does
  not represent to the public that the person is authorized to
  practice dentistry; and
               (3)  the person to whom the dental act is delegated is
  registered under Chapter 265 [holds the appropriate certificate],
  if registration [a certificate] is required to perform the act.
         SECTION 20.  Section 258.0511, Occupations Code, is amended
  by adding Subsection (a-1) to read as follows:
         (a-1)  The board by rule shall establish conditions under
  which the board may temporarily or permanently appoint a person as
  custodian of a dentist's billing or dental patient records. In
  adopting rules under this subsection, the board shall consider the
  death of a dentist, the mental or physical incapacitation of a
  dentist, and the abandonment of billing or dental patient records
  by a dentist as conditions for appointment of a custodian.
         SECTION 21.  Subchapter B, Chapter 258, Occupations Code, is
  amended by adding Section 258.0535 to read as follows:
         Sec. 258.0535.  DUTIES RELATED TO CERTAIN PRESCRIPTIONS.
  (a)  A dentist may not prescribe a drug listed in Subsection (b) to
  a patient unless the dentist has reviewed the patient's
  prescription history by accessing the prescription information
  submitted to the Texas State Board of Pharmacy as authorized by
  Section 481.076(a)(5), Health and Safety Code.
         (b)  Subsection (a) applies only to the prescribing of:
               (1)  opioids;
               (2)  benzodiazepines;
               (3)  barbiturates; or
               (4)  carisoprodol.
         (c)  Failure by a dentist to comply with the requirements of
  this section is grounds for disciplinary action under Section
  263.002.
         SECTION 22.  Section 258.054(c), Occupations Code, is
  amended to read as follows:
         (c)  A dentist may not authorize a dental assistant, other
  than a dental assistant described by Section 265.001(d), to make a
  dental x-ray unless the dental assistant is registered [holds an
  x-ray certificate issued] under Chapter 265 [Section 265.005].
         SECTION 23.  The heading to Subchapter D, Chapter 258,
  Occupations Code, is amended to read as follows:
  SUBCHAPTER D.  [ENTERAL] ADMINISTRATION OF ANESTHESIA
         SECTION 24.  Section 258.151, Occupations Code, is amended
  to read as follows:
         Sec. 258.151.  DEFINITIONS [DEFINITION]. In this
  subchapter:
               (1)  "High-risk patient" means a patient who has a
  level 3 or 4 classification according to the American Society of
  Anesthesiologists Physical Status Classification System.
               (2)  "Pediatric patient" means a patient younger than
  13 years of age[, "enteral" means any technique of administering
  anesthesia in which the anesthetic is absorbed through the
  gastrointestinal tract or oral mucosa. Examples of enterally
  administering anesthesia include administering an anesthetic
  orally, rectally, sublingually, or intranasally].
         SECTION 25.  Sections 258.153, 258.154, and 258.155,
  Occupations Code, are amended to read as follows:
         Sec. 258.153.  RULES. (a)  The board shall adopt rules to
  administer this subchapter, including rules to establish [by rule]
  the minimum standards for the [enteral] administration of
  anesthesia by a dentist.
         (b)  The rules must be designed to protect the health,
  safety, and welfare of the public and must include requirements
  relating to:
               (1)  for each type of permit held, the methods that may
  be used to [enterally] administer an anesthetic and the anesthetic
  agents that may be used;
               (2)  dental patient evaluation, diagnosis, counseling,
  and preparation;
               (3)  dental patient monitoring to be performed and
  equipment to be used during a procedure and during postprocedure
  monitoring;
               (4)  emergency procedures, drugs, and equipment,
  including education, training, and certification of personnel, as
  appropriate, and including protocols for transfers to a hospital;
               (5)  the documentation necessary to demonstrate
  compliance with this subchapter; [and]
               (6)  the period in which protocols or procedures
  covered by rules of the board shall be reviewed, updated, or
  amended; and
               (7)  the minimum components required to be included in
  a preoperative checklist to be used before administering anesthesia
  to a patient and retained in the patient's dental record.
         Sec. 258.154.  COMPLIANCE WITH ANESTHESIA RULES. (a)  A [On
  and after August 31, 2002, a] dentist who practices dentistry in
  this state and who [enterally] administers anesthesia or performs a
  procedure for which anesthesia is [enterally] administered shall
  comply with the rules adopted under this subchapter.
         (b)  The board may require a dentist to submit and comply
  with a corrective action plan to remedy or address any current or
  potential deficiencies with the dentist's [enteral] administration
  of anesthesia in accordance with this subtitle or rules of the
  board.
         Sec. 258.155.  [ANNUAL] PERMIT REQUIRED. (a)  The board
  shall issue permits to administer anesthesia in the following
  categories based on the extent to which the intended procedure will
  alter the patient's mental status and the method of anesthetic
  delivery:
               (1)  nitrous oxide;
               (2)  level 1:  minimal sedation;
               (3)  level 2:  moderate sedation (enteral
  administration);
               (4)  level 3:  moderate sedation (parenteral
  administration); and
               (5)  level 4:  deep sedation or general anesthesia.
         (b)  A [Not later than September 1, 2002, the board shall
  require each] dentist may not administer [who enterally
  administers] anesthesia unless the dentist obtains the appropriate 
  [or performs a procedure for which anesthesia is enterally
  administered to annually obtain a] permit issued under this section
  [from the board by completing a form prescribed by the board].
         (c)  The board shall set and impose a fee for issuance of a
  [the] permit in an amount designed to recover the costs of
  regulating a permit holder under this subchapter.
         (d) [(b)]  The board shall coordinate the times at which a
  permit must be renewed with the times at which a dentist's license
  must be renewed under Chapter 257 so that the times of registration,
  payment, notice, and imposition of penalties for late payment are
  similar and provide a minimum of administrative burden to the board
  and to dentists.
         SECTION 26.  Subchapter D, Chapter 258, Occupations Code, is
  amended by adding Sections 258.1551 through 258.1557 to read as
  follows:
         Sec. 258.1551.  PERMIT QUALIFICATIONS.  (a)  The board by
  rule shall establish the qualifications to obtain each permit
  described by Section 258.155, including the education and training
  required to obtain the permit.
         (b)  The rules adopted under Subsection (a) must require an
  applicant for a level 2, level 3, or level 4 permit to complete
  training on:
               (1)  pre-procedural patient evaluation, including the
  evaluation of a patient's airway and physical status as classified
  by the American Society of Anesthesiologists;
               (2)  the continuous monitoring of a patient's level of
  sedation during the administration of anesthesia; and
               (3)  the management of emergency situations.
         Sec. 258.1552.  JURISPRUDENCE EXAMINATION. (a)  The board
  shall develop and administer an online jurisprudence examination to
  determine a permit holder's knowledge of this subchapter, board
  rules, and other applicable laws of this state relating to the
  administration of anesthesia.
         (b)  A permit holder must pass the online jurisprudence
  examination developed by the board once every five years.
         Sec. 258.1553.  PORTABILITY OF ANESTHESIA SERVICES. The
  board by rule shall require a dentist who applies for the issuance
  or renewal of a permit under this subchapter to include in the
  application a statement indicating whether the dentist provides or
  will provide a permitted anesthesia service in more than one
  location.
         Sec. 258.1554.  ADMINISTRATION OF ANESTHESIA TO CERTAIN
  PATIENTS.  (a)  A permit holder under this subchapter may not
  administer anesthesia under a level 2, level 3, or level 4 permit to
  a pediatric or high-risk patient unless the permit holder has:
               (1)  demonstrated to the satisfaction of the board that
  the permit holder has advanced didactic and clinical training; and
               (2)  obtained authorization from the board under this
  section.
         (b)  The board by rule may establish limitations on the
  administration of anesthesia by a permit holder to a pediatric or
  high-risk patient.
         Sec. 258.1555.  CAPNOGRAPHY REQUIRED FOR CERTAIN ANESTHESIA
  SERVICES. A permit holder who is administering anesthesia for
  which a level 4 permit is required shall use capnography during the
  administration of anesthesia.
         Sec. 258.1556.  MINIMUM EMERGENCY PREPAREDNESS STANDARDS.
  (a)  The board shall adopt rules to establish minimum emergency
  preparedness standards and requirements for the administration of
  anesthesia under a permit issued under this subchapter. The rules
  must require a permit holder to:
               (1)  have available at any time the permit holder
  administers anesthesia:
                     (A)  an adequate and unexpired supply of drugs and
  anesthetic agents necessary for the safe administration of
  anesthesia; and
                     (B)  an automated external defibrillator, as
  defined by Section 779.001, Health and Safety Code;
               (2)  conduct periodic inspections of the permit
  holder's equipment in the manner and on the schedule determined by
  the board;
               (3)  maintain and make available to the board on
  request an equipment readiness log; and
               (4)  develop and annually update written policies,
  procedures, and training requirements, specific to the permit
  holder's equipment and drugs, for responding to emergency
  situations involving anesthesia.
         (b)  Rules adopted under Subsection (a)(4) must require a
  holder of a level 2, level 3, or level 4 permit to develop policies
  and procedures that include:
               (1)  advanced cardiac life support rescue protocols;
               (2)  advanced airway management techniques; and
               (3)  if the permit holder is authorized to administer
  anesthesia to pediatric patients, pediatric advanced life support
  rescue protocols.
         Sec. 258.1557.  EMERGENCY PREPAREDNESS PROTOCOLS. (a)  A
  permit holder shall develop emergency preparedness protocols,
  specific to the permit holder's practice setting, that establish a
  plan for the management of medical emergencies in each practice
  setting in which the dentist administers anesthesia.
         (b)  The board shall adopt rules prescribing the content that
  a permit holder must include in the emergency preparedness
  protocols developed under Subsection (a).  The rules must require a
  permit holder to include in the permit holder's emergency
  preparedness protocols the written policies, procedures, and
  training requirements described by Section 258.1556(a)(4).
         SECTION 27.  Section 258.156, Occupations Code, is amended
  to read as follows:
         Sec. 258.156.  INSPECTIONS. (a)  Except as provided by
  Subsection (h), the [The] board may conduct inspections of a
  dentist who applies for or holds a permit issued under this
  subchapter as necessary to enforce this subchapter, including
  inspections of an office site, equipment, a facility, and any
  document of the dentist [documents of a dentist's practice that
  relate to the enteral administration of anesthesia].  During an
  inspection under this section, the board may evaluate a dentist's
  competency in the administration of anesthesia.
         (b)  The board shall conduct an inspection with respect to a
  dentist who holds a level 2, level 3, or level 4 permit not later
  than the first anniversary of the date the permit is issued.
         (c)  The board by rule shall adopt a risk-based inspection
  policy for conducting inspections under this section.  The policy
  must require the board to take into consideration any previous
  disciplinary action taken against a permit holder for an
  anesthesia-related violation when determining whether an
  inspection is necessary.
         (d)  The board may contract with another state agency or
  qualified person to conduct these inspections.
         (e)  The [(b) Unless it would jeopardize an ongoing
  investigation, the] board is not required to give [shall provide at
  least five business days'] notice before conducting an [on-site]
  inspection under this section.
         (f)  The board shall maintain records of inspections
  conducted under this section.
         (g)  The board by rule may establish education and training
  requirements for inspectors who conduct inspections under this
  section.
         (h)  The board may not conduct an inspection under this
  section with respect to a dentist who administers anesthesia
  exclusively in a state-licensed hospital or state-licensed
  ambulatory surgical center. The board may by rule except from
  inspection under this section a dentist who administers anesthesia
  exclusively in any other facility that is subject to inspection by
  the Department of State Health Services or an accrediting body
  under state law. The board retains all other authority provided by
  this subtitle over a dentist described by this subsection 
  [(c)     This section does not require the board to make an on-site
  inspection of a dentist's office].
         SECTION 28.  Chapter 258, Occupations Code, is amended by
  adding Subchapter E to read as follows:
  SUBCHAPTER E.  ADVISORY COMMITTEE ON DENTAL ANESTHESIA
         Sec. 258.201.  DEFINITION. In this subchapter, "health care
  provider" means a person who provides services under a license,
  certificate, registration, or other authority issued by this state
  or another state to diagnose, prevent, alleviate, or cure a human
  illness or injury.
         Sec. 258.202.  ADVISORY COMMITTEE. (a)  The board shall
  establish an advisory committee to analyze and report on data and
  associated trends concerning anesthesia-related deaths or
  incidents as provided by this subchapter.  The advisory committee
  consists of six members appointed by the board in the manner
  provided by Section 258.203 and must include:
               (1)  a general dentist;
               (2)  a dentist anesthesiologist;
               (3)  an oral and maxillofacial surgeon;
               (4)  a pediatric dentist;
               (5)  a physician anesthesiologist; and
               (6)  a periodontist.
         (b)  In appointing members to the advisory committee, the
  board shall maintain a balanced representation of general dentists
  and specialists to ensure the advisory committee has expertise with
  respect to each permit category.
         (c)  A board member may not serve as a member of the advisory
  committee.  A former board member may not be appointed to the
  advisory committee until the second anniversary of the expiration
  of the member's term on the board.
         (d)  Chapter 2110, Government Code, does not apply to the
  size, composition, or duration of the advisory committee.
         Sec. 258.203.  APPLICATION PROCESS; APPOINTMENT OF
  COMMITTEE MEMBERS.  (a)  The board by rule shall develop and
  implement a process by which a person may apply to be appointed to
  the advisory committee and shall post the application and
  information regarding the application process on the board's
  Internet website.
         (b)  The presiding officer of the board shall review each
  application received and nominate for appointment to the advisory
  committee persons who meet the requirements of Section 258.202.  A
  person nominated under this subsection may not be appointed to the
  advisory committee except on the affirmative vote of at least seven
  members of the board.
         (c)  The presiding officer of the board shall designate one
  of the nominated members as presiding officer of the advisory
  committee, subject to approval of the board.
         Sec. 258.204.  TERMS; VACANCIES. The board by rule shall
  establish:
               (1)  the length of a term of a member of the advisory
  committee and the staggering of the terms of the members; and
               (2)  the manner in which a vacancy occurring during a
  member's term is filled.
         Sec. 258.205.  MEETINGS. The advisory committee is subject
  to Chapter 551, Government Code, except that the advisory committee
  may conduct a closed meeting to review confidential investigative
  files provided by the board under Section 258.206.
         Sec. 258.206.  COMPILATION AND ANALYSIS OF INFORMATION.
  (a)  The board shall identify complaints resolved by the board that
  involve anesthesia-related deaths or incidents and compile
  confidential, de-identified information derived from the
  investigative files on each complaint identified under this
  subsection.
         (b)  The board shall provide information compiled under
  Subsection (a) to the advisory committee.  The advisory committee
  shall analyze the information compiled under Subsection (a) to
  identify any trends and submit a report to the board at least
  annually on:
               (1)  the advisory committee's findings; and
               (2)  any recommendations for changes to board rules or
  this subtitle based on the advisory committee's analysis.
         (c)  On request of the advisory committee, the board may
  provide confidential, de-identified investigative files for review
  by the advisory committee.
         (d)  The data provided to the advisory committee under this
  section may not include identifying information of a patient or
  health care provider, including:
               (1)  the name, address, or date of birth of the patient
  or a member of the patient's family; or
               (2)  the name or specific location of a health care
  provider that treated the patient.
         (e)  The board shall post on the board's Internet website any
  recommendations or findings reported by the advisory committee.
         Sec. 258.207.  COUNSEL FOR ADVISORY COMMITTEE.  The board
  shall designate an attorney employed by the board to:
               (1)  act as counsel and provide legal advice to the
  advisory committee; and
               (2)  be present during the advisory committee's
  meetings and deliberations.
         Sec. 258.208.  CONFIDENTIALITY; PRIVILEGE. (a)  Any
  information pertaining to the investigation of an
  anesthesia-related death or incident is confidential.
         (b)  Confidential information that is acquired by the board
  and that includes identifying information of an individual or
  health care provider is privileged and may not be disclosed to any
  person.  Information that may not be disclosed under this
  subsection includes:
               (1)  the name and address of a patient or a member of
  the patient's family; and
               (2)  the identity of a health care provider that
  provided any services to the patient or a member of the patient's
  family.
         (c)  Advisory committee work product or information obtained
  or provided by the board under this subchapter is confidential.  
  This subsection does not prevent the advisory committee or board 
  from releasing information described by Subsection (d) or (e).
         (d)  Information is not confidential under this section if
  the information is:
               (1)  general information that cannot be connected with
  any specific individual, case, or health care provider; and
               (2)  presented as aggregate statistical information
  that describes a single data point.
         (e)  The advisory committee may publish statistical studies
  and research reports based on information that is confidential
  under this section, provided that the information:
               (1)  is published in the aggregate;
               (2)  does not identify a patient or the patient's
  family;
               (3)  does not include any information that could be
  used to identify a patient or the patient's family; and
               (4)  does not identify a health care provider.
         (f)  The board shall adopt and implement practices and
  procedures to ensure that information that is confidential under
  this section is not disclosed in violation of this section.
         (g)  Information that is confidential under this section is
  excepted from disclosure under Chapter 552, Government Code, as
  provided by Section 552.101 of that chapter.
         Sec. 258.209.  SUBPOENA AND DISCOVERY.  Advisory committee
  work product or information that is confidential under Section
  258.208 is privileged, is not subject to subpoena or discovery, and
  may not be introduced into evidence in any administrative, civil,
  or criminal proceeding against a patient, a member of the family of
  a patient, or a health care provider.
         Sec. 258.210.  IMMUNITY. (a)  A member of the advisory
  committee or a person employed by the board or acting in an advisory
  capacity to the advisory committee and who provides information,
  counsel, or services to the advisory committee is not liable for
  damages for an action taken within the scope of the functions of the
  advisory committee.
         (b)  Subsection (a) does not apply if the person acts with
  malice or without the reasonable belief that the action is
  warranted by the facts known to the person.
         (c)  This section does not provide immunity to a person
  described by Subsection (a) for a violation of a state or federal
  law or rule relating to the privacy of health information or the
  transmission of health information, including the Health Insurance
  Portability and Accountability Act of 1996 (Pub. L. No. 104-191)
  and rules adopted under that Act.
         Sec. 258.211.  FUNDING.  The board may accept gifts and
  grants from any source to fund the duties of the board and the
  advisory committee under this subchapter.
         SECTION 29.  Chapter 263, Occupations Code, is amended by
  adding Section 263.0001 to read as follows:
         Sec. 263.0001.  DEFINITION. In this chapter, "license"
  means a license, certificate, registration, permit, or other
  authorization that is issued under this subtitle.
         SECTION 30.  Section 263.001, Occupations Code, is amended
  to read as follows:
         Sec. 263.001.  GROUNDS FOR REFUSAL TO ISSUE LICENSE;
  APPLICATION OF OPEN MEETINGS LAW. (a)  The board may refuse to
  issue a license [by examination] to an [a dental or dental hygiene]
  applicant under this subtitle if the person:
               (1)  presents to the board fraudulent or false evidence
  of the person's qualification for examination or license;
               (2)  is guilty of any illegality, fraud, or deception
  during the examination or the process to secure a license;
               (3)  is habitually intoxicated or is addicted to drugs;
               (4)  commits a dishonest or illegal practice in or
  connected to dentistry or dental hygiene;
               (5)  is convicted of a felony under a federal law or law
  of this state; or
               (6)  is found to have violated a law of this state
  relating to the practice of dentistry within the 12 months
  preceding the date the person filed an application for a license to
  practice dentistry or dental hygiene.
         (b)  The board's deliberations with regard to an application
  for a license under this subtitle are exempt from Chapter 551,
  Government Code.
         SECTION 31.  Chapter 263, Occupations Code, is amended by
  adding Section 263.0025 to read as follows:
         Sec. 263.0025.  SUBMISSION TO MENTAL OR PHYSICAL EVALUATION.
  (a)  In enforcing Section 263.001(a)(3) or Section 263.002(a)(1),
  (7), or (11), the board or an authorized agent of the board, on
  probable cause, as determined by the board or agent, may request an
  applicant for or holder of a license to submit to a mental or
  physical evaluation by a physician or other health care
  professional designated by the board.
         (b)  If the applicant or license holder refuses to submit to
  the evaluation under Subsection (a), the board shall issue an order
  requiring the applicant or license holder to show cause why the
  applicant or license holder will not submit to the evaluation.  The
  board shall schedule a hearing on the order not later than the 30th
  day after the date notice is served on the applicant or license
  holder. The board shall notify the applicant or license holder of
  the order and hearing by personal service or certified mail, return
  receipt requested.
         (c)  At the hearing, the applicant or license holder and the
  applicant's or license holder's attorney are entitled to present
  testimony or other evidence to show why the applicant or license
  holder should not be required to submit to the evaluation. The
  applicant or license holder has the burden of proof to show why the
  applicant or license holder should not be required to submit to the
  evaluation.
         (d)  After the hearing, the board by order shall require the
  applicant or license holder to submit to the evaluation not later
  than the 60th day after the date of the order or withdraw the
  request for an evaluation, as applicable.
         SECTION 32.  Section 263.003, Occupations Code, is amended
  to read as follows:
         Sec. 263.003.  HEARING. A person is entitled to a hearing
  under Chapter 2001, Government Code, if the board proposes to:
               (1)  refuse to issue a license [by examination] to the
  person;
               (2)  reprimand or impose a fine on the person;
               (3)  place the person on probation after the person's
  license has been suspended; or
               (4)  suspend or revoke the license of the person.
         SECTION 33.  Section 263.0065(c), Occupations Code, is
  amended to read as follows:
         (c)  A complaint delegated under this section shall be
  referred for informal proceedings under Section 263.007 [263.0075]
  if:
               (1)  the committee of employees determines that the
  complaint should not be dismissed or settled;
               (2)  the committee is unable to reach an agreed
  settlement; or
               (3)  the affected license holder requests that the
  complaint be referred for informal proceedings.
         SECTION 34.  Section 263.007, Occupations Code, is amended
  by amending Subsection (b) and adding Subsections (c) through (k)
  to read as follows:
         (b)  Rules adopted under this section must require that:
               (1)  not later than the 180th day after the date the
  board's official investigation of a complaint is commenced, the
  board schedule an informal settlement conference unless good cause
  is shown by the board for not scheduling the conference by that
  date;
               (2)  the board give notice to the license holder of the
  time and place of the conference not later than the 45th day before
  the date the conference is held;
               (3)  the complainant and the license holder be provided
  an opportunity to be heard;
               (4)  the board's legal counsel or a representative of
  the attorney general be present to advise the board or the board's
  staff; and
               (5)  a member of the board's staff be at the conference
  to present the facts the staff reasonably believes the board could
  prove at a hearing by competent evidence or qualified witnesses
  [provide the complainant, if applicable and permitted by law, an
  opportunity to be heard;
               [(2)     provide the license holder an opportunity to be
  heard; and
               [(3)     require the presence of a member of the board's
  legal staff, if the board has a legal staff, or, if the board does
  not have a legal staff, an attorney from the attorney general's
  office to advise the board or the board's employees].
         (c)  The license holder is entitled at the conference to:
               (1)  reply to the staff's presentation; and
               (2)  present the facts the license holder reasonably
  believes the license holder could prove at a hearing by competent
  evidence or qualified witnesses.
         (d)  After ample time is given for the presentations, the
  informal settlement conference panel shall recommend that the
  investigation be closed or make a recommendation regarding the
  disposition of the case in the absence of a hearing under applicable
  law concerning contested cases.
         (e)  The board shall prioritize scheduling an informal
  settlement conference in accordance with Subsection (b)(1) to
  resolve a complaint against a license holder who has previously
  been the subject of disciplinary action by the board.
         (f)  A notice under Subsection (b)(2) must be accompanied by
  a written statement of the nature of the allegations and the
  information the board intends to use at the informal settlement
  conference.  If the board does not provide the statement or
  information at that time, the license holder may use that failure as
  grounds for rescheduling the conference.  If the complaint includes
  an allegation that the license holder has violated the standard of
  care in the practice of dentistry or dental hygiene, the notice must
  include a copy of the report by the expert reviewer.  The license
  holder must provide to the board the license holder's rebuttal not
  later than the 15th day before the date of the conference in order
  for that information to be considered at the conference.
         (g)  The board by rule shall define circumstances
  constituting good cause for purposes of Subsection (b)(1),
  including:
               (1)   an expert reviewer's delinquency in reviewing and
  submitting a report to the board under Section 255.0067;
               (2)  a temporary suspension of the license holder's
  license under Section 263.004; or
               (3)  the filing of a contested case against the license
  holder with the State Office of Administrative Hearings.
         (h)  The board by rule shall define circumstances
  constituting good cause to grant a request by a license holder for a
  continuance of the informal settlement conference.
         (i)  Information presented by the board or board staff in an
  informal settlement conference is confidential and not subject to
  disclosure under Chapter 552, Government Code.
         (j)  On request by the license holder under review, the board
  shall make a recording of the informal settlement conference
  proceeding.  The recording is a part of the investigative file and
  may not be released to a third party unless authorized under this
  subtitle. The board may charge the license holder a fee to cover
  the cost of recording the proceeding.
         (k)  The board shall provide a copy of the recording to the
  license holder on the license holder's request.
         SECTION 35.  Chapter 263, Occupations Code, is amended by
  adding Sections 263.0071, 263.0072, 263.0073, and 263.0074 to read
  as follows:
         Sec. 263.0071.  DENTAL REVIEW COMMITTEE. (a)  The dental
  review committee consists of nine members appointed by the governor
  as follows:
               (1)  six dentist members;
               (2)  two dental hygienist members; and
               (3)  one registered dental assistant member.
         (b)  A member of the committee serves a six-year term.
         (c)  If a vacancy occurs during a member's term, the governor
  shall appoint a replacement to fill the unexpired term.
         (d)  A member of the committee is entitled to receive a per
  diem for actual duty in the same manner provided for board members.
         (e)  A member of the committee is subject to law and the rules
  of the board, including Sections 252.003, 252.007, and 252.010, as
  if the committee member were a member of the board, except that a
  committee member is not subject to Chapter 572, Government Code.  
  The training program a committee member must complete under Section
  252.010 must be an abbreviated version of the program under that
  section that is limited to training relevant to serving on a
  committee.
         Sec. 263.0072.  INFORMAL SETTLEMENT CONFERENCE PANEL.
  (a)  The board shall appoint members of the board and the dental
  review committee to serve, on a rotating basis, as panelists on an
  informal settlement conference panel for purposes of this section.
         (b)  In an informal settlement conference under Section
  263.007, the board shall appoint at least two panelists to
  determine whether an informal disposition is appropriate. At least
  one of the panelists must be a dentist.
         (c)  The board by rule shall require that at least one
  panelist be physically present at the informal settlement
  conference and may authorize another panelist to appear by video
  conference.
         (d)  Notwithstanding Subsection (b), an informal settlement
  conference may be conducted by one panelist if the license holder
  who is the subject of the complaint waives the requirement that at
  least two panelists conduct the conference. If the license holder
  waives that requirement, the panelist may be a dentist, a dental
  hygienist, or a member who represents the public.
         (e)  Notwithstanding Subsections (b) and (d), an informal
  settlement conference conducted under Section 263.007 to show
  compliance with an order or remedial plan of the board may be
  conducted by one panelist.
         Sec. 263.0073.  ROLES AND RESPONSIBILITIES OF PARTICIPANTS
  IN INFORMAL SETTLEMENT CONFERENCE. (a)  At an informal settlement
  conference under Section 263.007, the panel shall make
  recommendations for the disposition of the complaint or allegation.
  The panel may request the assistance of a board employee at any
  time.
         (b)  Board employees shall present a summary of the
  allegations against the license holder and of the facts pertaining
  to the allegation that the employees reasonably believe may be
  proven by competent evidence at a formal hearing.
         (c)  An attorney for the board shall act as counsel to the
  panel and shall be present during the informal settlement
  conference and the panel's deliberations to advise the panel on
  legal issues that arise during the proceeding.  The attorney may ask
  questions of participants in the conference to clarify any
  statement made by the participant.  The attorney shall provide to
  the panel a historical perspective on comparable cases that have
  appeared before the board, keep the proceedings focused on the case
  being discussed, and ensure that the board's employees and the
  license holder have an opportunity to present information related
  to the case.  During the panel's deliberations, the attorney may be
  present only to advise the panel on legal issues and to provide
  information on comparable cases that have appeared before the
  board.
         (d)  The panel and board employees shall provide an
  opportunity for the license holder and the license holder's
  authorized representative to reply to the board employees'
  presentation and to present oral and written statements and facts
  that the license holder and representative reasonably believe could
  be proven by competent evidence at a formal hearing.
         (e)  An employee of the board who participated in the
  presentation of the allegation or information gathered in the
  investigation of the complaint, the license holder, the license
  holder's authorized representative, the complainant, the
  witnesses, and members of the public may not be present during the
  deliberations of the panel.  Only the members of the panel and the
  attorney serving as counsel to the panel may be present during the
  deliberations.
         (f)  During the deliberations, the panel may not reconsider
  an expert panel's determinations that are included in a final
  written report issued under Section 255.0067.
         (g)  The panel shall recommend the dismissal of the complaint
  or allegations or, if the panel determines that the license holder
  has violated a statute or board rule, may recommend board action and
  terms for an informal settlement of the case.
         (h)  The panel's recommendations under Subsection (g) must
  be made in writing and presented to the license holder and the
  license holder's authorized representative.  The license holder may
  accept the proposed settlement within the time established by the
  panel at the informal settlement conference.  If the license holder
  rejects the proposed settlement or does not act within the required
  time, the board may proceed with the filing of a formal complaint
  with the State Office of Administrative Hearings.
         Sec. 263.0074.  DISMISSAL OF BASELESS COMPLAINT. If, during
  the 180-day period prescribed by Section 263.007(b)(1), the board
  determines that the complaint is a baseless or unfounded complaint,
  the board shall dismiss the complaint and include a statement in the
  records of the complaint that the reason for the dismissal is
  because the complaint was baseless or unfounded. The board shall
  adopt rules that establish criteria for determining that a
  complaint is baseless or unfounded.
         SECTION 36.  Section 263.0076, Occupations Code, is amended
  to read as follows:
         Sec. 263.0076.  INFORMAL SETTLEMENT CONFERENCE NOTICE
  REGARDING CERTAIN COMPLAINTS. [(a)] If an informal settlement
  conference is not scheduled for a complaint before the 180-day
  period prescribed by Section 263.007(b)(1), the board shall provide
  notice to all parties to the complaint.  The notice must include an
  explanation of the reason why the informal settlement conference
  has not been scheduled.  The notice under this section is not
  required if the notice would jeopardize an investigation [will be
  held under Section 263.0075, notice of the time and place of the
  conference must be given to the license holder not later than the
  45th day before the date the conference is held].
         [(b)     The notice required by Subsection (a) must be
  accompanied by a written statement of the specific allegations
  against the license holder and the information the board intends to
  use at the informal settlement conference.   If the board does not
  provide the statement or information when the notice is provided,
  the license holder may use that failure as grounds for rescheduling
  the conference.
         [(c)     The license holder must provide to the board the
  license holder's rebuttal not later than the 15th day before the
  date of the conference in order for that information to be
  considered at the conference.
         [(d)     On request by a license holder under review, the board
  shall make a recording of the informal settlement conference.   The
  recording is a part of the investigative file and may not be
  released to a third party unless authorized under this subtitle.  
  The board may charge the license holder a fee to cover the cost of
  recording the conference.   The board shall provide a copy of the
  recording to the license holder on the license holder's request.]
         SECTION 37.  Section 264.011, Occupations Code, is amended
  to read as follows:
         Sec. 264.011.  INFORMAL ASSESSMENT OF ADMINISTRATIVE
  PENALTY. This subchapter does not prevent the board from assessing
  an administrative penalty using an informal proceeding under
  Section 263.007 [263.003].
         SECTION 38.  Section 265.001, Occupations Code, is amended
  to read as follows:
         Sec. 265.001.  REGISTRATION REQUIRED FOR CERTAIN DENTAL
  ACTS.  (a)  Unless the dental assistant is registered under this
  chapter, a dental assistant may not:
               (1)  make a dental x-ray; or
               (2)  monitor the administration of nitrous oxide.
         (b)  The board may adopt and enforce rules requiring a dental
  assistant to register with the board to perform other dental acts
  [the registration of dental assistants] as necessary to protect the
  public health and safety.
         (c)  The board shall maximize the efficient administration
  of this chapter by:
               (1)  developing a system to track the number of
  registrations held by a dental assistant under this chapter; and
               (2)  coordinating the times at which a dental
  assistant's registrations must be renewed so that the times of
  registration, payment, notice, and imposition of penalties for late
  payment are similar and the administrative burden to the board and
  to the dental assistant is reduced.
         (d)  Notwithstanding Subsection (a)(1), a dental assistant
  who is hired as a dental assistant for the first time and who has not
  previously been issued a registration to make dental x-rays may
  make dental x-rays without complying with this chapter until the
  first anniversary of the date the dental assistant is hired.
         SECTION 39.  Chapter 265, Occupations Code, is amended by
  adding Sections 265.0015, 265.0016, and 265.0017 to read as
  follows:
         Sec. 265.0015.  ELIGIBILITY REQUIREMENTS FOR REGISTRATION.
  (a)  The board by rule shall establish the requirements for each
  type of registration issued under this chapter, including requiring
  a dental assistant to:
               (1)  hold a high school diploma or its equivalent;
               (2)  complete an educational program approved by the
  board that provides instruction on:
                     (A)  a dental act that requires a registration
  under this chapter;
                     (B)  basic life support;
                     (C)  infection control; and
                     (D)  jurisprudence;
               (3)  pass an examination approved or administered by
  the board; and
               (4)  meet any additional qualifications established by
  the board.
         (b)  The board may approve courses of instruction and
  examinations that are provided by private entities for the purposes
  of this section.
         Sec. 265.0016.  FEES. The board shall set and collect fees
  in amounts that are reasonable and necessary to cover the costs of
  administering this chapter, including registration and renewal
  fees.
         Sec. 265.0017.  REGISTRATION EXPIRATION AND RENEWAL. (a)  A
  registration under this chapter is valid for two years.
         (b)  A dental assistant may renew a registration by paying
  the required renewal fee and complying with any other renewal
  requirements established by the board.
         (c)  A dental assistant whose registration has expired may
  not engage in an activity that requires registration until the
  registration has been renewed.
         (d)  The board by rule may adopt a system under which
  registrations expire on various dates during the year.  For the year
  in which the expiration date is changed, the board shall prorate
  registration fees on a monthly basis so that each registration
  holder pays only that portion of the registration fee that is
  allocable to the number of months during which the registration is
  valid. On renewal of the registration on the new expiration date,
  the total renewal fee is payable.
         SECTION 40.  Section 265.003, Occupations Code, is amended
  by amending Subsections (a) and (a-1) and adding Subsections (c)
  and (d) to read as follows:
         (a)  A dental assistant who is not registered under this
  chapter [professionally licensed] may be employed by and work in
  the office of a licensed and practicing dentist and perform one or
  more delegated dental acts under:
               (1)  the direct supervision, direction, and
  responsibility of the dentist, including[:
                     [(A)     the application of a pit and fissure
  sealant;
                     [(B)     coronal polishing, if the dental assistant
  holds a certificate under Section 265.006; and
                     [(C)]  the application of fluoride varnish; or
               (2)  the general supervision, direction, and
  responsibility of the dentist, limited to:
                     (A)  the making of dental x-rays in compliance
  with Section 265.001(d) [Section 265.005]; and
                     (B)  the provision of interim treatment of a minor
  emergency dental condition to an existing patient of the treating
  dentist.
         (a-1)  A treating dentist who delegates the provision of
  interim treatment of a minor emergency dental condition to a dental
  assistant under Subsection (a)(2) [(a)(2)(B)] shall:
               (1)  delegate the procedure orally or in writing before
  the dental assistant performs the procedure;
               (2)  retain responsibility for the procedure; and
               (3)  schedule a follow-up appointment with the patient
  within a reasonable time.
         (c)  A delegating dentist remains responsible for the dental
  acts of a registered or nonregistered dental assistant performing
  the delegated dental acts.
         (d)  A dental assistant to whom a delegation is made may not
  represent to the public that the dental assistant is authorized to
  practice dentistry or dental hygiene.
         SECTION 41.  Section 265.005, Occupations Code, is amended
  by adding Subsection (p) to read as follows:
         (p)  This section expires September 1, 2018.
         SECTION 42.  Section 265.007, Occupations Code, is amended
  by adding Subsection (d) to read as follows:
         (d)  This section expires September 1, 2018.
         SECTION 43.  Chapter 265, Occupations Code, is amended by
  adding Section 265.008 to read as follows:
         Sec. 265.008.  CONTINUING EDUCATION REQUIRED FOR
  REGISTRATION RENEWAL. The board by rule shall establish continuing
  education requirements for dental assistants registered under this
  chapter, including a minimum number of hours of continuing
  education required to renew a registration.
         SECTION 44.  The heading to Subchapter C, Chapter 266,
  Occupations Code, is amended to read as follows:
  SUBCHAPTER C.  BOARD POWERS AND DUTIES [OF COUNCIL AND BOARD]
         SECTION 45.  Section 266.152(d), Occupations Code, is
  amended to read as follows:
         (d)  The owner of a dental laboratory registered with the
  board on September 1, 1987, is exempt from Subsection (a) if:
               (1)  the registration of the laboratory has been timely
  renewed [each year] since that date, and all registration fees have
  been paid;
               (2)  the beneficial ownership of at least 51 percent of
  the laboratory has not been transferred; and
               (3)  the owner is employed on the laboratory's premises
  for not less than 30 hours each week.
         SECTION 46.  The heading to Section 266.153, Occupations
  Code, is amended to read as follows:
         Sec. 266.153.  APPLICATION FOR REGISTRATION; TERM.
         SECTION 47.  Section 266.153, Occupations Code, is amended
  by amending Subsection (a) and adding Subsection (d) to read as
  follows:
         (a)  An owner or manager of a dental laboratory shall
  [annually]:
               (1)  apply to the board for the registration of each
  dental laboratory doing business in this state to which the owner or
  manager is connected or in which the owner or manager has an
  interest; and
               (2)  pay the application fee set by the board.
         (d)  A dental laboratory registration issued under this
  chapter is valid for a term of one or two years, as determined by
  board rule.
         SECTION 48.  Sections 266.154(a) and (c), Occupations Code,
  are amended to read as follows:
         (a)  An applicant for renewal of a dental laboratory
  registration must provide evidence satisfactory to the board that
  at least one employee who works on the dental laboratory's
  premises:
               (1)  has completed the minimum number of [at least 12]
  hours of continuing education during the previous registration
  period as required by board rule; or
               (2)  is certified as required by Section 266.152(a), if
  applicable.
         (c)  If the owner or manager of a dental laboratory fails to
  renew the dental laboratory's registration and pay the [annual]
  renewal fee before the date the registration expires, the board
  shall suspend the registration certificate of the laboratory.
         SECTION 49.  The following provisions of the Occupations
  Code are repealed:
               (1)  Sections 256.0531(h), (i), and (j);
               (2)  Section 262.001(1);
               (3)  Subchapter B, Chapter 262;
               (4)  Section 262.102(c);
               (5)  Section 262.1025;
               (6)  Section 262.103;
               (7)  Section 263.0075;
               (8)  Section 265.003(b);
               (9)  Section 265.004;
               (10)  Section 265.006;
               (11)  Section 266.001(1);
               (12)  Subchapter B, Chapter 266;
               (13)  Section 266.101; and
               (14)  Sections 266.102(a) and (d).
         SECTION 50.  Not later than March 1, 2018, the State Board of
  Dental Examiners shall:
               (1)  adopt rules and fees necessary to implement
  Chapters 258 and 265, Occupations Code, as amended by this Act; and
               (2)  adopt rules necessary to implement Chapter 263,
  Occupations Code, as amended by this Act.
         SECTION 51.  (a)  The term of a member of the State Board of
  Dental Examiners serving on September 1, 2017, expires on that
  date.
         (b)  Not later than December 1, 2017, the governor shall
  appoint 11 members to the State Board of Dental Examiners in
  accordance with Section 252.001(a), Occupations Code, as amended by
  this Act.  The governor shall appoint:
               (1)  two dentist members and one dental hygienist
  member to terms expiring February 1, 2019;
               (2)  two dentist members, one dental hygienist member,
  and one public member to terms expiring February 1, 2021; and
               (3)  two dentist members, one dental hygienist member,
  and one public member to terms expiring February 1, 2023.
         (c)  Notwithstanding Section 252.001, Occupations Code, as
  amended by this Act, the members whose terms expire under
  Subsection (a) of this section shall continue to perform the duties
  of office as a 15-member board until six members are appointed under
  Subsection (b) of this section and qualified.
         (d)  The governor may appoint to the board under Subsection
  (b) of this section a member whose term expires under Subsection (a)
  of this section.  The expired term of a member described by this
  subsection does not constitute a full term for purposes of Section
  252.004(b), Occupations Code.
         SECTION 52.  Not later than December 1, 2017, the State Board
  of Dental Examiners shall appoint the members of the advisory
  committee established under Subchapter E, Chapter 258, Occupations
  Code, as added by this Act, in the manner provided by that
  subchapter.
         SECTION 53.  Not later than December 1, 2017, the governor
  shall appoint the members of the dental review committee in
  accordance with Section 263.0071, Occupations Code, as added by
  this Act.  In making the appointments, the governor shall appoint:
               (1)  three members to terms expiring February 1, 2019;
               (2)  three members to terms expiring February 1, 2021;
  and
               (3)  three members to terms expiring February 1, 2023.
         SECTION 54.  (a)  Except as provided by Subsection (b) of
  this section, Section 252.010, Occupations Code, as amended by this
  Act, applies to a member of the State Board of Dental Examiners
  appointed before, on, or after the effective date of this Act.
         (b)  A member of the board appointed after the effective date
  of this Act who, before the effective date of this Act, completed
  the training program required by Section 252.010, Occupations Code,
  as that law existed before the effective date of this Act, is
  required to complete additional training only on the subjects added
  by this Act to the training program as required by Section 252.010,
  Occupations Code. A board member described by this subsection may
  not vote, deliberate, or be counted as a member in attendance at a
  meeting of the board held on or after December 1, 2017, until the
  member completes the additional training.
         SECTION 55.  Section 258.0535, Occupations Code, as added by
  this Act, applies only to a prescription issued on or after
  September 1, 2018. A prescription issued before September 1, 2018,
  is governed by the law in effect on the date the prescription was
  issued, and the former law is continued in effect for that purpose.
         SECTION 56.  Not later than September 1, 2022, the State
  Board of Dental Examiners shall conduct an inspection under Section
  258.156, Occupations Code, as amended by this Act, with respect to a
  dentist who holds a level 2, level 3, or level 4 permit issued under
  Section 258.155, Occupations Code, before the effective date of
  this Act.
         SECTION 57.  (a)  On the effective date of this Act, a
  certificate issued under former Section 265.004 or 265.006,
  Occupations Code, expires.
         (b)  The repeal of a law by this Act does not entitle a person
  to a refund of an application, licensing, or other fee paid by the
  person before the effective date of this Act.
         SECTION 58.  (a)  On and after September 1, 2018, the State
  Board of Dental Examiners shall issue a dental x-ray registration
  under Section 265.001, Occupations Code, as amended by this Act, to
  a dental assistant who renews an unexpired certificate of
  registration issued under former Section 265.005, Occupations
  Code, and who meets the continuing education requirements
  established by the board under Section 265.008, Occupations Code,
  as added by this Act.  A dental assistant described by this
  subsection is not required to meet the eligibility requirements of
  Section 265.0015, Occupations Code, as added by this Act, to obtain
  or renew a registration issued under this subsection.
         (b)  On and after September 1, 2018, the State Board of
  Dental Examiners shall issue a nitrous oxide monitoring
  registration under Section 265.001, Occupations Code, as amended by
  this Act, to a dental assistant who holds a current nitrous oxide
  monitoring certificate issued by the State Board of Dental
  Examiners before that date and who meets the continuing education
  requirements established by the board under Section 265.008,
  Occupations Code, as added by this Act.  A dental assistant
  described by this subsection is not required to meet the
  eligibility requirements of Section 265.0015, Occupations Code, as
  added by this Act, to obtain or renew a registration issued under
  this subsection.
         SECTION 59.  Section 265.008, Occupations Code, as added by
  this Act, applies only to the renewal of a registration on or after
  September 1, 2018.
         SECTION 60.  On September 1, 2019, a certificate of
  registration issued under former Section 265.005, Occupations
  Code, or a nitrous oxide monitoring certificate issued by the State
  Board of Dental Examiners, expires.
         SECTION 61.  (a)  Chapter 263, Occupations Code, as amended
  by this Act, applies only to the investigation or disposition of a
  complaint filed with the State Board of Dental Examiners on or after
  March 1, 2018. A complaint filed before that date is governed by
  the law in effect on the date the complaint was filed, and the
  former law is continued in effect for that purpose.
         (b)  The changes in law made by this Act do not affect the
  validity of a disciplinary action or other proceeding that was
  initiated before the effective date of this Act and that is pending
  before a court or other governmental entity on that date.
         SECTION 62.  (a)  A violation of a law that is repealed by
  this Act is governed by the law in effect on the date the violation
  was committed, and the former law is continued in effect for that
  purpose.
         (b)  For purposes of this section, a violation was committed
  before the effective date of this Act if any element of the
  violation occurred before that date.
         SECTION 63.  (a)  Except as provided by Subsections (b) and
  (c) of this section, this Act takes effect September 1, 2017.
         (b)  Sections 258.155 and 258.156, Occupations Code, as
  amended by this Act, and Section 258.1554, Occupations Code, as
  added by this Act, take effect March 1, 2018.
         (c)  Sections 258.002, 258.054, and 265.001, Occupations
  Code, as amended by this Act, take effect September 1, 2018.
 
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