Senate Bill No. 208–Senator Rawson

 

February 20, 2001

____________

 

Referred to Committee on Human Resources and Facilities

 

SUMMARY—Makes various changes to provisions concerning public dental health. (BDR 40‑738)

 

FISCAL NOTE:            Effect on Local Government: No.

                                    Effect on the State: Contains Appropriation not included in Executive Budget.

 

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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

 

AN ACT relating to public dental health; providing for the appointment of a state dental health officer and a state public health dental hygienist; establishing their duties; providing for the authorization of a person to practice public health dental hygiene; making appropriations; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

1-1    Section 1. Chapter 439 of NRS is hereby amended by adding thereto

1-2  the provisions set forth as sections 2 and 3 of this act.

1-3    Sec. 2.  1.  The state board of health shall appoint a state dental

1-4  health officer, who is in the unclassified service of the state. The state

1-5  dental health officer must:

1-6    (a) Be a resident of this state;

1-7    (b) Hold a current license to practice dentistry issued pursuant to

1-8  chapter 631 of NRS; and

1-9    (c) Be appointed on the basis of his education, training and

1-10  experience and his interest in public dental health and related programs.

1-11    2.  The state dental health officer shall:

1-12    (a) Determine the needs of the residents of this state for public dental

1-13  health;

1-14    (b) Provide the state board of health with advice regarding public

1-15  dental health;

1-16    (c) Make recommendations to the state board of health and the

1-17  legislature regarding programs in this state for public dental health;

1-18    (d) Supervise the activities of the state public health dental hygienist;

1-19  and

2-1    (e) Seek such information and advice from a dental school of the

2-2  University and Community College System of Nevada as necessary to

2-3  carry out his duties.

2-4    3.  Except as otherwise provided in this subsection and NRS 284.143,

2-5  the state dental health officer shall devote all of his time to the business

2-6  of his office and shall not pursue any other business or vocation or hold

2-7  any other office of profit. Notwithstanding the provisions of NRS

2-8  281.127, the state dental health officer may engage in academic

2-9  instruction, research and studies at a dental school of the University and

2-10  Community College System of Nevada.

2-11    Sec. 3.  1.  The state board of health shall appoint a state public

2-12  health dental hygienist, who is in the unclassified service of the state.

2-13  The state public health dental hygienist must:

2-14    (a) Be a resident of this state;

2-15    (b) Hold a current license to practice dental hygiene issued pursuant

2-16  to chapter 631 of NRS with a special endorsement issued pursuant to

2-17  section 4 of this act; and

2-18    (c) Be appointed on the basis of his education, training and

2-19  experience and his interest in public health dental hygiene and related

2-20  programs.

2-21    2.  The state public health dental hygienist:

2-22    (a) Shall assist the state dental health officer in carrying out his

2-23  duties; and

2-24    (b) May:

2-25      (1) Make recommendations to the state dental health officer

2-26  regarding programs in this state for public health dental hygiene; and

2-27      (2) Perform any acts authorized pursuant to section 4 of this act.

2-28    Sec. 4.  Chapter 631 of NRS is hereby amended by adding thereto a

2-29  new section to read as follows:

2-30    1.  The board shall, upon application by a dental hygienist who is

2-31  licensed pursuant to this chapter and has such qualifications as the

2-32  board specifies by regulation, issue a special endorsement of his license

2-33  allowing him to practice public health dental hygiene pursuant to

2-34  subsection 2.

2-35    2.  The state dental health officer may authorize a person who holds a

2-36  special endorsement issued pursuant to subsection 1 to provide or cause

2-37  to be provided such services for the promotion of public health dental

2-38  hygiene as the state dental health officer deems appropriate. Such

2-39  services:

2-40    (a) May be provided at schools, community centers, hospitals, nursing

2-41  homes and such other locations as the state dental health officer deems

2-42  appropriate.

2-43    (b) May not be provided at a dental office that is not operated by a

2-44  public entity.

2-45    Sec. 5.  NRS 631.310 is hereby amended to read as follows:

2-46    631.310  1.  Except as otherwise provided in NRS 631.271[,] and

2-47  section 4 of this act, the holder of a license or renewal certificate to

2-48  practice dental hygiene may practice dental hygiene in this state in the

2-49  following places:

3-1    (a) In the office of any licensed dentist.

3-2    (b) In a clinic or in clinics in the public schools of this state as an

3-3  employee of the health division of the department of human resources.

3-4    (c) In a clinic or in clinics in a state institution as an employee of the

3-5  institution.

3-6    (d) In a clinic established by a hospital approved by the board as an

3-7  employee of the hospital where service is rendered only to patients of the

3-8  hospital, and upon the authorization of a member of the dental staff.

3-9    (e) In an accredited school of dental hygiene.

3-10    (f) In other places if specified in a regulation adopted by the board.

3-11    2.  A dental hygienist may perform only the services which are

3-12  authorized by a dentist licensed in the State of Nevada, unless otherwise

3-13  provided in a regulation adopted by the board.

3-14    3.  Except as otherwise provided in section 4 of this act or specifically

3-15  authorized by a regulation adopted by the board, a dental hygienist shall

3-16  not provide services to a person unless that person is a patient of the dentist

3-17  who authorized the performance of those services.

3-18    Sec. 6.  NRS 631.313 is hereby amended to read as follows:

3-19    631.313  1.  A licensed dentist may assign to a person in his employ

3-20  who is a dental hygienist, dental assistant or other person directly or

3-21  indirectly involved in the provision of dental care only such intraoral tasks

3-22  as may be permitted by a regulation of the board or by the provisions of

3-23  this chapter.

3-24    2.  The performance of these tasks must be:

3-25    (a) If performed by a dental assistant or a person, other than a dental

3-26  hygienist, who is directly or indirectly involved in the provision of dental

3-27  care, under the supervision of the licensed dentist who made the

3-28  assignment.

3-29    (b) If performed by a dental hygienist, authorized by the licensed dentist

3-30  of the patient for whom the tasks will be performed[.] , except as

3-31  otherwise provided in section 4 of this act.

3-32    3.  No such assignment is permitted that requires:

3-33    (a) The diagnosis, treatment planning, prescribing of drugs or

3-34  medicaments, or authorizing the use of restorative, prosthodontic or

3-35  orthodontic appliances.

3-36    (b) Surgery on hard or soft tissues within the oral cavity or any other

3-37  intraoral procedure that may contribute to or result in an irremediable

3-38  alteration of the oral anatomy.

3-39    (c) The administration of general anesthetics other than by an

3-40  anesthetist or anesthesiologist licensed in this state.

3-41    (d) The performance of a task outside the authorized scope of practice

3-42  of the employee who is being assigned the task.

3-43    4.  A dental hygienist may, pursuant to regulations adopted by the

3-44  board, administer local anesthesia or nitrous oxide in a health care facility,

3-45  as defined in NRS 449.800, if:

3-46    (a) He is so authorized by the licensed dentist of the patient to whom the

3-47  local anesthesia or nitrous oxide is administered; and

4-1    (b) The health care facility has licensed medical personnel and

4-2  necessary emergency supplies and equipment available when the local

4-3  anesthesia or nitrous oxide is administered.

4-4    Sec. 7.  NRS 631.346 is hereby amended to read as follows:

4-5    631.346  The following acts, among others, constitute unprofessional

4-6  conduct:

4-7    1.  Employing, directly or indirectly, any student or any suspended or

4-8  unlicensed dentist or dental hygienist to perform operations of any kind to

4-9  treat or correct the teeth or jaws, except as provided in this chapter;

4-10    2.  [Giving] Except as otherwise provided in section 4 of this act,

4-11  giving a public demonstration of methods of practice any place other than

4-12  the office where the licensee is known to be regularly engaged in this

4-13  practice;

4-14    3.  Employing, procuring, inducing, aiding or abetting a person not

4-15  licensed or registered as a dentist to engage in the practice of dentistry, but

4-16  a patient shall not be deemed to be an accomplice, employer, procurer,

4-17  inducer, aider or abettor;

4-18    4.  For a dental hygienist, practicing in any place not authorized [by]

4-19  pursuant to this chapter; or

4-20    5.  Practicing while his license is suspended or without a renewal

4-21  certificate.

4-22    Sec. 8.  1.  There is hereby appropriated from the state general fund

4-23  to the state board of health the sum of $350,000 to carry out the provisions

4-24  of sections 2 and 3 of this act.

4-25    2.  Any remaining balance of the appropriation made by subsection 1

4-26  must not be committed for expenditure after June 30, 2003, and reverts to

4-27  the state general fund as soon as all payments of money committed have

4-28  been made.

4-29    Sec. 9.  1.  There is hereby appropriated from the state general fund

4-30  to the board of regents of the University of Nevada the sum of $250,000 to

4-31  develop the curriculum and standards necessary for a student in the

4-32  University and Community College System of Nevada to earn a bachelor

4-33  of science degree in dental hygiene or a master’s degree in public health

4-34  dental hygiene.

4-35    2.  Any remaining balance of the appropriation made by subsection 1

4-36  must not be committed for expenditure after June 30, 2003, and reverts to

4-37  the state general fund as soon as all payments of money committed have

4-38  been made.

4-39    Sec. 10.  1.  This section and sections 8 and 9 of this act become

4-40  effective upon passage and approval.

4-41    2.  Sections 1 to 7, inclusive, of this act become effective on July 1,

4-42  2001.

 

4-43  H