1468L.02I                                                                                                                                                  D. ADAM CRUMBLISS, Chief Clerk



To repeal sections 332.011 and 332.311, RSMo, and to enact in lieu thereof two new sections relating to dental hygienists.

Be it enacted by the General Assembly of the state of Missouri, as follows:

            Section A. Sections 332.011 and 332.311, RSMo, are repealed and two new sections enacted in lieu thereof, to be known as sections 332.011 and 332.311, to read as follows:

            332.011. As used in this chapter, the following words and terms mean:

            (1) "Accredited dental hygiene school", any program which teaches a course in dental hygiene which is accredited by the Commission on Dental Accreditation of the American Dental Association and which shall have a minimum of two academic years of curriculum provided in a college or institution of higher education;

            (2) "Accredited dental school", any college, university, school, or other institution which teaches dentistry which has been certified by the American Dental Association;

            (3) "Board", the Missouri dental board;

            (4) "Certified dental assistant", a dental assistant who is currently certified by the Dental Assisting National Board, Inc.;

            (5) "Dental assistant", an employee of a duly registered and currently licensed dentist in Missouri, other than either a dental hygienist or a certified dental assistant;

            (6) "Expanded-functions dental assistant", any dental assistant who has passed a basic dental assisting skills mastery examination or a certified dental assistant, either of whom has successfully completed a board-approved expanded-functions course, passed a competency examination, and has obtained a permit authorizing them to perform expanded-functions duties from the Missouri dental board;

            (7) "Expanded-functions duties", reversible acts that would be considered the practice of dentistry as defined in section 332.071 that the board specifies by rule may be delegated to a dental assistant or dental hygienist who possesses an expanded-functions permit;

            (8) "Public health setting", a location where dental services authorized by subsection 2 of section 332.311 are performed so long as the delivery of services are sponsored by an entity which includes:

            (a) The department of health and senior services;

            (b) A county health department;

            (c) A city health department operating under a city charter;

            (d) A combined city/county health department;

            (e) Any nonprofit community center qualified as exempt from federal taxation under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended, including a community health center that receives funding authorized by Section 329, 330, or 340 of the federal Public Health Services Act;

            (f) A Medicaid-enrolled pediatric office;

            (g) Head Start/Early Head Start centers;

            (h) Missouri public and private schools;

            (i) Hospitals; and

            (j) Long-term care facilities;

            (9) "Sponsored", the relationship between a dental hygienist and any entity listed in subdivision (8) of this section with which the dental hygienist is employed or enters into a service contract.

            332.311. 1. Except as provided in subsection 2 of this section, a duly registered and currently licensed dental hygienist may only practice as a dental hygienist so long as the dental hygienist is employed by a dentist who is duly registered and currently licensed in Missouri, or as an employee of such other person or entity approved by the board in accordance with rules promulgated by the board. In accordance with this chapter and the rules promulgated by the board pursuant thereto, a dental hygienist shall only practice under the supervision of a dentist who is duly registered and currently licensed in Missouri, except as provided in subsection 2 of this section.

            2. A duly registered and currently licensed dental hygienist [who has been in practice at least three years and] who is practicing in a public health setting, as defined in section 332.011, may provide fluoride treatments, teeth cleaning, radiographs, and sealants[, if appropriate, to children who are eligible for medical assistance, pursuant to chapter 208,] without the supervision of a dentist. [Medicaid] MO HealthNet shall reimburse any eligible [provider who provides] dental hygienist or public health setting in which fluoride treatments, teeth cleaning, radiographs, and sealants [to eligible children] are provided. Those public health settings in which a dental hygienist may practice without the supervision of a dentist [shall be established jointly by the department of health and senior services and by the Missouri dental board by rule] are defined in section 332.011, with any additional settings to be approved by the Missouri dental board.