Senate Bill No. 208–Senator Rawson
CHAPTER..........
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; and providing other matters properly relating thereto.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 439 of NRS is hereby amended by adding thereto
the provisions set forth as sections 2 and 3 of this act.
Sec. 2. 1. The health division shall appoint a state dental health
officer, who is in the unclassified service of the state. The state dental
health officer must:
(a) Be a resident of this state;
(b) Hold a current license to practice dentistry issued pursuant to
chapter 631 of NRS; and
(c) Be appointed on the basis of his education, training and
experience and his interest in public dental health and related programs.
2. The state dental health officer shall:
(a) Determine the needs of the residents of this state for public dental
health;
(b) Provide the health division with advice regarding public dental
health;
(c) Make recommendations to the health division and the legislature
regarding programs in this state for public dental health;
(d) Supervise the activities of the state public health dental hygienist;
and
(e) Seek such information and advice from a dental school of the
University and Community College System of Nevada as necessary to
carry out his duties.
3. Except as otherwise provided in this subsection, the state dental
health officer shall devote all of his time to the business of his office and
shall not pursue any other business or vocation or hold any other office
of profit. Notwithstanding the provisions of NRS 281.127 and 284.143,
the state dental health officer may engage in academic instruction,
research and studies at a dental school of the University and Community
College System of Nevada.
4. The health division may solicit and accept gifts and grants to pay
the costs associated with the position of state dental health officer.
Sec. 3. 1. The health division shall appoint a state public health
dental hygienist, who is in the unclassified service of the state. The state
public health dental hygienist must:
(a) Be a resident of this state;
(b) Hold a current license to practice dental hygiene issued pursuant
to chapter 631 of NRS with a special endorsement issued pursuant to
section 7 of this act; and
(c) Be appointed on the basis of his education, training and
experience and his interest in public health dental hygiene and related
programs.
2. The state public health dental hygienist:
(a) Shall assist the state dental health officer in carrying out his
duties; and
(b) May:
(1) Make recommendations to the health division regarding
programs in this state for public health dental hygiene; and
(2) Perform any acts authorized pursuant to section 7 of this act.
3. Except as otherwise provided in this subsection, the state public
health dental hygienist shall devote all of his time to the business of his
office and shall not pursue any other business or vocation or hold any
other office of profit. Notwithstanding the provisions of NRS 281.127
and 284.143, the state public health dental hygienist may engage in
academic instruction, research and studies in a program of the
University and Community College System of Nevada.
4. The health division may solicit and accept gifts and grants to pay
the costs associated with the position of state public health dental
hygienist.
Sec. 3.5 Chapter 396 of NRS is hereby amended by adding thereto a
new section to read as follows:
The board of regents may, to the extent that money is available,
develop the curriculum and standards required for a student in the
system to earn a bachelor of science degree in dental hygiene or a
master’s degree in public health dental hygiene.
Sec. 4. Chapter 631 of NRS is hereby amended by adding thereto the
provisions set forth as sections 5, 6 and 7 of this act.
Sec. 5. “Conscious sedation” means a minimally depressed level of
consciousness, produced by a pharmacologic or nonpharmacologic
method or a combination thereof, in which the patient retains the ability
independently and continuously to maintain an airway and to respond
appropriately to physical stimulation and verbal commands.
Sec. 6. “Deep sedation” means a controlled state of depressed
consciousness, produced by a pharmacologic or nonpharmacologic
method or a combination thereof, and accompanied by a partial loss of
protective reflexes and the inability to respond purposefully to verbal
commands.
Sec. 7. 1. The board shall, upon application by a dental hygienist
who is licensed pursuant to this chapter and has such qualifications as
the board specifies by regulation, issue a special endorsement of his
license allowing him to practice public health dental hygiene pursuant to
subsection 2.
2. The state dental health officer may authorize a person who holds a
special endorsement issued pursuant to subsection 1 to provide or cause
to be provided such services for the promotion of public health dental
hygiene as the state dental health officer deems appropriate. Such
services:
(a) May be provided at schools, community centers, hospitals, nursing
homes and such other locations as the state dental health officer deems
appropriate.
(b) May not be provided at a dental office that is not operated by a
public or nonprofit entity.
Sec. 8. NRS 631.005 is hereby amended to read as follows:
631.005 As used in this chapter, unless the context otherwise requires,
the words and terms defined in NRS 631.015 to 631.105, inclusive, and
sections 5 and 6 of this acthave the meanings ascribed to them in those
sections.
Sec. 9. NRS 631.265 is hereby amended to read as follows:
631.265 1. No licensed dentist or person who holds a restricted
license issued pursuant to NRS 631.275 may administer or supervise
directly the administration of general anesthesia, conscious sedation or
deep sedation to dental patients unless he has been issued a permit
authorizing him to do so by the board.
2. The board may issue a permit authorizing a licensed dentist or
person who holds a restricted license issued pursuant to NRS 631.275 to
administer or supervise directly the administration of general anesthesia,
conscious sedation or deep sedation to dental patients under such
standards, conditions and other requirements as the board shall by
regulation prescribe.
[3. As used in this section:
(a) “Conscious sedation” means a minimally depressed level of
consciousness, produced by a pharmacologic or nonpharmacologic
method or a combination thereof, in which the patient retains the ability
independently and continuously to maintain an airway and to respond
appropriately to physical stimulation and verbal commands.
(b) “Deep sedation” means a controlled state of depressed
consciousness, produced by a pharmacologic or nonpharmacologic
method or a combination thereof, and accompanied by a partial loss of
protective reflexes and the inability to respond purposefully to verbal
commands.]
Sec. 10. NRS 631.275 is hereby amended to read as follows:
631.275 1. Except as otherwise provided in subsection 2, the board
shall, without examination, issue a restricted license to practice dentistry
to a person who:
(a) Has a valid license to practice dentistry issued pursuant to the laws
of another state or the District of Columbia;
(b) Has received a degree from a dental school or college accredited by
the [American Dental Association] Commission on Dental Accreditation
[,] of the American Dental Association or its successor organization; and
(c) Has entered into a contract with a facility approved by the health
division of the department of human resources to provide publicly funded
dental services exclusively to persons of low income for the duration of
the restricted license.
2. The board shall not issue a restricted license to a person:
(a) Who has failed to pass the examination of the board;
(b) Who has been refused a license in this state, another state or territory
of the United States or the District of Columbia; or
(c) Whose license to practice dentistry has been revoked in this state,
another state or territory of the United States or the District of Columbia.
3. A person to whom a restricted license is issued pursuant to
subsection 1:
(a) May perform dental services only:
(1) Under the general supervision of the state dental health officer
or the supervision of a dentist who is licensed to practice dentistry in this
state and appointed by the health division of the department of human
resources to supervise dental care that is provided in a facility which has
entered into a contract with the person to whom a restricted license is
issued and which is approved by the health division ; [of the department;]
and
(2) In accordance with the contract required pursuant to paragraph (c)
of that subsection.
(b) Shall not, for the duration of the restricted license, engage in the
private practice of dentistry, which includes, without limitation, providing
dental services to a person who pays for the services.
4. A person who receives a restricted license must pass the
examination of the board within 3 years after receiving his restricted
license. If the person fails to pass that examination, the board shall revoke
the restricted license.
5. The board may revoke a restricted license at any time.
Sec. 11. NRS 631.290 is hereby amended to read as follows:
631.290 1. Any person is eligible to take an examination for a
license to practice dental hygiene in this state who:
(a) Is of good moral character;
(b) Is over 18 years of age;
(c) Is a citizen of the United States or is lawfully entitled to remain and
work in the United States; and
(d) Is a graduate of [an accredited] a school of dental hygiene [.] or
other institution that awards at least an associate degree upon
completion of the program and that is accredited by a regional
educational accrediting organization that is recognized by the United
States Department of Education. The program of dental hygiene must:
(1) Be accredited by the Commission on Dental Accreditation of the
American Dental Association or its successor specialty accrediting
organization; and
(2) Include a curriculum of not less than 2 years of academic
instruction in dental hygiene or its academic equivalent.
2. To determine whether a person has good moral character the board
may consider whether his license to practice dental hygiene in another
state has been suspended or revoked or whether he is currently involved in
any disciplinary action concerning his license in that state.
Sec. 12. (Deleted by amendment.)
Sec. 13. NRS 631.310 is hereby amended to read as follows:
631.310 1. Except as otherwise provided in NRS 631.271[,] and
section 7 of this act, the holder of a license or renewal certificate to
practice dental hygiene may practice dental hygiene in this state in the
following places:
(a) In the office of any licensed dentist.
(b) In a clinic or in clinics in the public schools of this state as an
employee of the health division of the department of human resources.
(c) In a clinic or in clinics in a state institution as an employee of the
institution.
(d) In a clinic established by a hospital approved by the board as an
employee of the hospital where service is rendered only to patients of the
hospital, and upon the authorization of a member of the dental staff.
(e) In an accredited school of dental hygiene.
(f) In other places if specified in a regulation adopted by the board.
2. A dental hygienist may perform only the services which are
authorized by a dentist licensed in the State of Nevada, unless otherwise
provided in a regulation adopted by the board.
3. Except as otherwise provided in section 7 of this act or specifically
authorized by a regulation adopted by the board, a dental hygienist shall
not provide services to a person unless that person is a patient of the
dentist who authorized the performance of those services.
Sec. 14. NRS 631.313 is hereby amended to read as follows:
631.313 1. A licensed dentist may assign to a person in his employ
who is a dental hygienist, dental assistant or other person directly or
indirectly involved in the provision of dental care only such intraoral tasks
as may be permitted by a regulation of the board or by the provisions of
this chapter.
2. The performance of these tasks must be:
(a) If performed by a dental assistant or a person, other than a dental
hygienist, who is directly or indirectly involved in the provision of dental
care, under the supervision of the licensed dentist who made the
assignment.
(b) If performed by a dental hygienist, authorized by the licensed dentist
of the patient for whom the tasks will be performed[.] , except as
otherwise provided in section 7 of this act.
3. No such assignment is permitted that requires:
(a) The diagnosis, treatment planning, prescribing of drugs or
medicaments, or authorizing the use of restorative, prosthodontic or
orthodontic appliances.
(b) Surgery on hard or soft tissues within the oral cavity or any other
intraoral procedure that may contribute to or result in an irremediable
alteration of the oral anatomy.
(c) The administration of general [anesthetics other than by an
anesthetist or anesthesiologist licensed in this state.] anesthesia, conscious
sedation or deep sedation except as otherwise authorized by regulations
adopted by the board.
(d) The performance of a task outside the authorized scope of practice
of the employee who is being assigned the task.
4. A dental hygienist may, pursuant to regulations adopted by the
board, administer local anesthesia or nitrous oxide in a health care facility,
as defined in NRS 449.800, if:
(a) He is so authorized by the licensed dentist of the patient to whom the
local anesthesia or nitrous oxide is administered; and
(b) The health care facility has licensed medical personnel and
necessary emergency supplies and equipment available when the local
anesthesia or nitrous oxide is administered.
Sec. 15. NRS 631.346 is hereby amended to read as follows:
631.346 The following acts, among others, constitute unprofessional
conduct:
1. Employing, directly or indirectly, any student or any suspended or
unlicensed dentist or dental hygienist to perform operations of any kind to
treat or correct the teeth or jaws, except as provided in this chapter;
2. [Giving] Except as otherwise provided in section 7 of this act,
giving a public demonstration of methods of practice any place other than
the office where the licensee is known to be regularly engaged in this
practice;
3. Employing, procuring, inducing, aiding or abetting a person not
licensed or registered as a dentist to engage in the practice of dentistry, but
a patient shall not be deemed to be an accomplice, employer, procurer,
inducer, aider or abettor;
4. For a dental hygienist, practicing in any place not authorized [by]
pursuant to this chapter; or
5. Practicing while his license is suspended or without a renewal
certificate.
Sec. 16. Section 7.5 of Senate Bill No. 133 of this session is hereby
amended to read as follows:
Sec. 7.5 NRS 631.290 is hereby amended to read as follows:
631.290 1. Any person is eligible to [take an examination]
apply for a license to practice dental hygiene in this state who:
(a) Is of good moral character;
(b) Is over 18 years of age;
(c) Is a citizen of the United States or is lawfully entitled to remain
and work in the United States; and
(d) Is a graduate of a school of dental hygiene or other institution
that awards at least an associate degree upon completion of the
program and that is accredited by a regional educational accrediting
organization that is recognized by the United States Department of
Education. The program of dental hygiene must:
(1) Be accredited by the Commission on Dental Accreditation of
the American Dental Association or its successor specialty
accrediting organization; and
(2) Include a curriculum of not less than 2 years of academic
instruction in dental hygiene or its academic equivalent.
2. To determine whether a person has good moral character , the
board may consider whether his license to practice dental hygiene in
another state has been suspended or revoked or whether he is
currently involved in any disciplinary action concerning his license in
that state.
Sec. 17. Notwithstanding the provisions of sections 2 and 3 of this act,
for the fiscal years 2001-2002 and 2002-2003:
1. The health division may, in lieu of complying with the provisions of
sections 2 and 3 of this act, appoint a state dental health officer and a state
public health dental hygienist from the lists of names submitted by the
board of regents of the University of Nevada for terms expiring on June
30, 2003. If the board of regents fails to submit a list for any position, the
health division may appoint any qualified person.
2. Unless the health division provides otherwise, each person
appointed pursuant to subsection 1 shall carry out the duties set forth in
sections 2 and 3 of this act without additional compensation and using the
office, equipment, staff and other resources provided to him by the
University and Community College System of Nevada for his existing
position.
Sec. 18. This act becomes effective on July 1, 2001.
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