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  H.B. No. 3824
 
 
 
 
AN ACT
  relating to the administration of a local anesthetic agent by a
  dental hygienist.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 258.001, Occupations Code, is amended to
  read as follows:
         Sec. 258.001.  IMPERMISSIBLE DELEGATIONS. A dentist may not
  delegate:
               (1)  an act to an individual who, by board order, is
  prohibited from performing the act;
               (2)  any of the following acts to a person not licensed
  as a dentist or dental hygienist:
                     (A)  the removal of calculus, deposits, or
  accretions from the natural and restored surfaces of exposed human
  teeth and restorations in the human mouth;
                     (B)  root planing or the smoothing and polishing
  of roughened root surfaces or exposed human teeth; or
                     (C)  any other act the delegation of which is
  prohibited by board rule;
               (3)  any of the following acts to a person not licensed
  as a dentist:
                     (A)  comprehensive examination or diagnosis and
  treatment planning;
                     (B)  a surgical or cutting procedure on hard or
  soft tissue;
                     (C)  the prescription of a drug, medication, or
  work authorization;
                     (D)  the taking of an impression for a final
  restoration, appliance, or prosthesis;
                     (E)  the making of an intraoral occlusal
  adjustment;
                     (F)  direct pulp capping, pulpotomy, or any other
  endodontic procedure;
                     (G)  the final placement and intraoral adjustment
  of a fixed or removable appliance; or
                     (H)  the placement of any final restoration; [or]
               (4)  the authority to an individual to administer a
  local anesthetic agent, inhalation sedative agent, parenteral
  sedative agent, or general anesthetic agent, including as a
  teledentistry dental service as that term is defined by Section
  111.001, if the individual is not licensed as:
                     (A)  a dentist with a permit issued by the board
  for the procedure being performed, if a permit is required;
                     (B)  a certified registered nurse anesthetist
  licensed by the Texas Board of Nursing, only if the delegating
  dentist holds a permit issued by the board for the procedure being
  performed, if a permit is required; or
                     (C)  a physician anesthesiologist licensed by the
  Texas Medical Board; or
               (5)  the authority to a dental hygienist to administer
  a local anesthetic agent unless: 
                     (A)  the dental hygienist:
                           (i)  administers the local anesthetic agent
  by infiltration for purposes of a procedure the dental hygienist is
  authorized to perform; 
                           (ii)  has passed a board-approved
  certification examination relating to the administration of a local
  anesthetic agent;
                           (iii)  either: 
                                 (a)  has completed a board-approved
  course of study designed to train dental hygienists to administer a
  local anesthetic agent by infiltration; or
                                 (b)  during the preceding year, was
  authorized to administer a local anesthetic agent by: 
                                       (1)  a branch of the United States
  armed forces; or
                                       (2)  another state with clinical
  and didactic education requirements substantially equivalent to
  the requirements of a course approved by the board under
  Sub-subparagraph (a); and
                           (iv)  complies with any applicable rules
  adopted by the board establishing minimum standards for the
  administration of a local anesthetic agent;
                     (B)  the delegating dentist is physically present
  in the facility where the procedure is occurring and is
  continuously aware of the patient's physical status and well-being;
  and
                     (C)  the patient to whom the local anesthetic
  agent is administered is:
                           (i)  at least 18 years of age; and 
                           (ii)  not sedated, or is sedated using only
  nitrous oxide-oxygen inhalation.
         SECTION 2.  Section 262.002(a), Occupations Code, is amended
  to read as follows:
         (a)  A person practices dental hygiene if the person:
               (1)  removes accumulated matter, tartar, deposits,
  accretions, or stains, other than mottled enamel stains, from the
  natural and restored surface of exposed human teeth and
  restorations in the human mouth;
               (2)  smoothes roughened root surfaces;
               (3)  polishes exposed human teeth, restorations in the
  human mouth, or roughened root surfaces;
               (4)  topically applies drugs to the surface tissues of
  the human mouth or the exposed surface of human teeth;
               (5)  makes dental x-rays; [and]
               (6)  administers a local anesthetic agent under the
  authorization and supervision of a dentist in compliance with
  Section 258.001(5); and
               (7)  performs any other service, task, or procedure
  prescribed by board rule.
         SECTION 3.  (a) Not later than January 1, 2024, the State
  Board of Dental Examiners shall:
               (1)  prescribe by rule the requirements for a course to
  train dental hygienists to administer a local anesthetic agent
  consistent with Section 258.001, Occupations Code, as amended by
  this Act;
               (2)  develop a procedure for the approval of courses
  described by Subdivision (1) of this subsection; and
               (3)  adopt rules to administer Sections 258.001 and
  262.002, Occupations Code, as amended by this Act, including rules
  to establish the minimum standards for the administration of a
  local anesthetic agent by a dental hygienist consistent with those
  sections.
         (b)  A rule adopted under Subsection (a)(1) of this section
  must require that a course be offered in a classroom setting at an
  educational institution accredited by the Commission on Dental
  Accreditation of the American Dental Association.
         SECTION 4.  This Act takes effect September 1, 2023.
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
 
         I certify that H.B. No. 3824 was passed by the House on May
  12, 2023, by the following vote:  Yeas 133, Nays 7, 2 present, not
  voting.
 
  ______________________________
  Chief Clerk of the House   
 
 
         I certify that H.B. No. 3824 was passed by the Senate on May
  24, 2023, by the following vote:  Yeas 31, Nays 0.
 
  ______________________________
  Secretary of the Senate    
  APPROVED:  _____________________
                     Date          
   
            _____________________
                   Governor