Session of 1998
By Health Care Reform Legislative Oversight Committee
            9             AN ACT concerning the dental practices act; concerning dental services
10             for dentally indigent persons; amending K.S.A. 1997 Supp. 65-1456
11             and 65-1466 and repealing the existing sections.
13       Be it enacted by the Legislature of the State of Kansas:
14           Section 1. K.S.A. 1997 Supp. 65-1456 is hereby amended to read as
15       follows: 65-1456. (a) The board may suspend or revoke the license, license
16       certificate and renewal certificate of any registered and licensed dentist
17       who shall permit any dental hygienist operating under such dentist's su-
18       pervision to perform any operation other than that permitted under the
19       provisions of article 14 of chapter 65 of the Kansas Statutes Annotated,
20       or acts amendatory thereof, and may suspend or revoke the license of any
21       hygienist found guilty of performing any operation other than those per-
22       mitted under article 14 of chapter 65 of the Kansas Statutes Annotated,
23       or acts amendatory thereof. No license or certificate of any dentist or
24       dental hygienist shall be suspended or revoked in any administrative pro-
25       ceedings without first complying with the notice and hearing require-
26       ments of the Kansas administrative procedure act.
27           (b) The practice of dental hygiene shall include those educational,
28       preventive, and therapeutic procedures which result in the removal of
29       extraneous deposits, stains and debris from the teeth and the rendering
30       of smooth surfaces of the teeth to the depths of the gingival sulci. In-
31       cluded among those educational, preventive and therapeutic procedures
32       are the instruction of the patient as to daily personal care, protecting the
33       teeth from dental caries, the scaling and polishing of the crown surfaces
34       and the planing of the root surfaces, in addition to the curettage of those
35       soft tissues lining the free gingiva to the depth of the gingival sulcus and
36       such additional educational, preventive and therapeutic procedures as the
37       board may establish by rules and regulations.
38           (c) Subject to such prohibitions, limitations and conditions as the
39       board may prescribe by rules and regulations, any licensed dental hy-
40       gienist may practice dental hygiene and may also perform such dental
41       service as may be performed by a dental assistant under the provisions of
42       K.S.A. 65-1423 and amendments thereto.
43           (d) Except as otherwise provided in this section, the practice of dental

HB 2622


  1       hygiene shall be performed under the direct or indirect supervision of a
  2       licensed dentist at the office of such licensed dentist. The board may
  3       designate by rules and regulations the procedures which may be per-
  4       formed by a dental hygienist under direct supervision and the procedures
  5       which may be performed under the indirect supervision of a licensed
  6       dentist. As used in this section, ``indirect supervision'' means that the
  7       dentist is in the dental office, authorizes the procedures and remains in
  8       the dental office while the procedures are being performed and ``direct
  9       supervision'' means that the dentist is in the dental office, personally
10       diagnoses the condition to be treated, personally authorizes the procedure
11       and before dismissal of the patient evaluates the performance.
12           (e) The practice of dental hygiene may be performed at an adult care
13       home, hospital long-term care unit, state institution, local health depart-
14       ment or indigent health care clinic on a resident of a facility, client or
15       patient thereof so long as:
16           (1) A licensed dentist has delegated the performance of the service,
17       task or procedure;
18           (2) the dental hygienist is under the supervision and responsibility of
19       the dentist;
20           (3) either the supervising dentist is personally present or the services,
21       tasks and procedures are limited to the cleaning of teeth, education and
22       preventive care;
23           (4) the supervising dentist examines the patient at the time the dental
24       hygiene procedure is performed or has examined the patient during the
25       12 calendar months preceding performance of the procedure; and
26           (5) nothing in this subsection (e) shall be construed to prevent a den-
27       tal hygienist from providing dental education in a school setting; and
28           (6) the provisions of this subsection (e) shall expire on July 1, 1998.
29           (f) The board may issue a permit to a licensed dental hygienist to
30       provide dental screening as an employee of the state of Kansas, or any
31       subdivision thereof, at any public institution or facility under the super-
32       vision of the governing body of such public institution or facility under
33       such terms and conditions as the board may reasonably establish in such
34       permit. Such permit shall be for a period of one year and shall be subject
35       to renewal annually at the time the license for dental hygiene is renewed.
36           (g) In addition to the duties specifically mentioned in subsection (b)
37       of K.S.A. 65-1456, and amendments thereto, any duly licensed and reg-
38       istered dental hygienist may:
39           (1) Give fluoride treatments as a prophylactic measure, as defined by
40       the United States public health service and as recommended for use in
41       dentistry;
42           (2) remove overhanging restoration margins and periodontal surgery
43       materials by hand scaling instruments; and

HB 2622


  1           (3) administer local block and infiltration anaesthesia and nitrous ox-
  2       ide. (A) The administration of local anaesthesia shall be performed only
  3       under the direct supervision of a licensed dentist at the office of the
  4       licensed dentist. (B) Each dental hygienist who administers local anaes-
  5       thesia shall have completed courses of instruction in local anaesthesia and
  6       nitrous oxide which have been approved by the board.
  7           (h) (1) The courses of instruction required in subsection (g)(3)(B) of
  8       K.S.A. 65-1456, and amendments thereto, shall provide a minimum of 12
  9       hours of instruction at a teaching institution accredited by the American
10       dental association.
11           (2) The courses of instruction shall include courses which provide
12       both didactic and clinical instruction in: (A) Theory of pain control; (B)
13       anatomy; (C) medical history; (D) pharmacology; and (E) emergencies
14       and complications.
15           (3) Certification in cardiac pulmonary resuscitation shall be required
16       in all cases.
17           Sec. 2. K.S.A. 1997 Supp. 65-1466 is hereby amended to read as
18       follows: 65-1466. (a) Notwithstanding any other provision of the dental
19       practices act, a not-for-profit corporation having the status of an organi-
20       zation under 26 United States Code Annotated 501(c)(3) which is also a
21       facility qualified under subsection (b) of K.S.A. 65-431 and amendments
22       thereto to select and employ professional personnel, an indigent health
23       care clinic as defined by the rules and regulations of the secretary of
24       health and environment, a federally qualified health center, or a local
25       health department may employ or otherwise contract with a person li-
26       censed under the dental practices act to provide dental services to dentally
27       indigent persons.
28           (b) Dentally indigent persons are those persons who are: (1) Deter-
29       mined to be a member of a family unit earning at or below 200% of
30       poverty income guidelines based on the annual update of ``poverty income
31       guidelines'' published in the federal register by the United States de-
32       partment of health and human services and are not indemnified against
33       costs arising from medical and hospital care or dental care by a policy of
34       accident and sickness insurance or an employee health benefits plan; or
35       (2) eligible for medicaid; or (3) qualified for Indian health services. This
36       subsection shall not be construed to prohibit an entity under subsection
37       (a) which enters into an arrangement with a licensee under the dental
38       practices act for purposes of providing services to dentally indigent per-
39       sons pursuant to subsection (a) from defining ``dentally indigent persons''
40       more restrictively than such term is defined under this subsection.
41           (c) A licensee under the dental practices act who enters into an ar-
42       rangement with an entity under subsection (a) to provide dental services
43       pursuant to subsection (a): (1) Shall not be subject to having the licensee's

HB 2622


  1       license certificate suspended or revoked by the board solely as a result of
  2       such arrangement; and (2) may not permit another person who is not
  3       licensed in Kansas as a dentist, and is not otherwise competent, to engage
  4       in the clinical practice of dentistry. No entity under subsection (a) or any
  5       other person may direct or interfere or attempt to direct or interfere with
  6       a licensed dentist's professional judgment and competent practice of den-
  7       tistry.
  8           (d) A dentist who is classified as ``retired'' by the Kansas dental board
  9       is not required to pay the annual renewal fee or comply with the dental
10       continuing education requirements if the dentist elects to provide dental
11       services to the indigent through one of the entities specified in subsection
12       (a). A ``retired'' dentist providing such services shall be required to comply
13       with the annual renewal requirements of the Kansas dental board.
14           (e) The Kansas dental board may adopt rules and regulations as nec-
15       essary to carry out the provisions of this section.
16           (e) (f) This section shall be part of and supplemental to the dental
17       practices act. The provisions of this section shall expire on July 1, 1998.
18           Sec. 3. K.S.A. 1997 Supp. 65-1456 and 65-1466 are hereby repealed.
19           Sec. 4. This act shall take effect and be in force from and after its
20       publication in the statute book.