TITLE 22. EXAMINING BOARDS

PART 5. STATE BOARD OF DENTAL EXAMINERS

CHAPTER 100. GENERAL PROVISIONS

22 TAC §100.3

The State Board of Dental Examiners (Board) proposes an amendment to §100.3, concerning the Board's Organization and Structure. This rule amendment will define the Board's structure to comply with changes made in SB313.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to establish Board membership in compliance with the legislature's modifications to the Dental Practice Act. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed amendment may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The amendment is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§100.3.Organization and Structure.

(a) General. The board shall consist of eleven [15] members appointed by the governor with the advice and consent of the senate, as follows:

(1) six [eight] reputable dentist members who reside in this state and have been actively engaged in the practice of dentistry for at least the five years preceding appointment;

(2) three [two] reputable dental hygienist members who reside in this state and have been actively engaged in the practice of dental hygiene for at least the five years preceding appointment; and,

(3) two [five] members who represent the public.

(b) Privileges of office. Members of the board have full and identical privileges, except that only dentist members may participate in the decision to pass or fail an applicant for a license to practice dentistry during the clinical portion of the board examinations.

(c) Terms of office. Members of the board serve staggered six-year terms. The terms of one-third of the members shall expire on February 1 of each odd-numbered year. A member may not serve more than two consecutive full terms. The completion of the unexpired portion of a term does not constitute service for a full term for purposes of this subsection.

(d) Eligibility. Refer to Occupations Code §252.002.

(e) Membership and employee restrictions. Refer to Occupations Code §252.003.

(f) Compensation. Each member of the board is entitled to receive a per diem set by legislative appropriation for each day the member engages in board business, and may receive reimbursement for travel expenses in accordance with the travel policies of the state of Texas and the Board of Dental Examiners.

(g) Professional Conduct. A board member should strive to achieve and project the highest standards of professional conduct. Such standards include:

(1) A board member should avoid conflicts of interest. If a conflict of interest should unintentionally occur, the board member should recuse himself or herself from participating in any matter before the board that could be affected by the conflict.

(2) A board member should avoid the use of the board member's official position to imply professional superiority or competence.

(3) A board member should avoid the use of the board member's official position as an endorsement in any health care related matter.

(4) A board member should refrain from making any statement that implies that the board member is speaking for the board if the board has not voted on an issue or unless the board has given the board member such authority.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703940

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


22 TAC §100.9

The State Board of Dental Examiners (Board) proposes an amendment to §100.9, concerning the Advisory Committees and Workgroups Established by the Board. This proposed amendment will eliminate the Dental Hygiene Advisory Committee and the Blue Ribbon Panel on Dental Sedation/Anesthesia Safety and provide for the establishment of the Advisory Committee on Dental Anesthesia.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to eliminate the Dental Hygiene Advisory Committee and the Blue Ribbon Panel on Dental Sedation/Anesthesia Safety committees and establish the Advisory Committee on Dental Anesthesia in compliance with SB 313. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed amendment may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The amendment is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§100.9.Advisory Committees and Workgroups Established by the Board.

(a) In addition to any specific statutory authority to establish particular advisory committees, the board may authorize advisory committees from outside the board's membership to advise the board on rulemaking, pursuant to §2001.031 of the Texas Government Code and subject to chapter 2110 of the Texas Government Code, State Agency Advisory Committees.

(b) Creation and dissolution. The board, in a regularly scheduled meeting, may vote to establish advisory committees and workgroups from outside the board's membership to address specific subjects, purposes, or ends. Unless continued by a vote of the board, advisory committees and workgroups outside the board's membership are abolished the sooner of one year from the date of creation or when the specific subject, purpose, or end for which the advisory committee or workgroup was established, have been served.

(c) Chair. Each advisory committee or workgroup shall select from among its members a chairperson who shall preside over the advisory committee or workgroup and shall report to the board or agency as needed.

(d) Membership. The presiding officer shall determine the method by which members are designated to the advisory committee or workgroup. The membership of an advisory committee must provide a balanced representation between members of the dental industry and consumers of the dental industry. Advisory committee and workgroup members shall serve terms as determined by the board.

(e) Board member liaisons. The presiding officer may appoint board member or board members to serve as a liaison(s) to an advisory committee or workgroup and report to the board the recommendations of the advisory committee or workgroup for consideration by the board. The role of a board member liaison is limited to clarifying the board's charge and intent to the advisory committee or workgroup.

(f) Agency staff liaisons. The executive director of the agency may assign agency staff to assist the advisory committee and workgroup.

(g) Meetings and participation. All meetings shall be open to the public and noticed on the Secretary of State's website to allow the public an opportunity to participate.

(h) Purpose. The board rule establishing the advisory committee or workgroup shall state the purpose and tasks of the committee and describe the manner in which the committee will report to the board.

(i) Committee actions. The actions of advisory committees are recommendations only.

(j) The following are advisory committees and workgroups established by the board or established by statute: Advisory Committee on Dental Anesthesia, established by Subchapter E of Chapter 258 of the Texas Occupations Code.

[(1) Dental Hygiene Advisory Committee, established by Subchapter B of Chapter 262 of the Texas Occupations Code; and]

[(2) Advisory Committee- Blue Ribbon Panel on Dental Sedation/Anesthesia Safety, established by board rule 100.12.]

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703941

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


CHAPTER 104. CONTINUING EDUCATION

22 TAC §104.1

The State Board of Dental Examiners (Board) proposes an amendment to §104.1, concerning continuing education requirements. This rule amendment will provide for continuing education credits for examiners for Central Regional Dental Testing Services, Inc.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated is to provide more fairness to examiners as well as more incentive to serve as an examiner. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed amendment may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The amendment is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§104.1.Requirement.

As a prerequisite to the annual renewal of a dental or dental hygiene license, proof of completion of 12 hours of acceptable continuing education is required.

(1) Each licensee shall select and participate in the continuing education courses endorsed by the providers identified in §104.2 of this title (relating to Providers). A licensee, other than a licensee who resides outside of the United States, who is unable to meet education course requirements may request that alternative courses or procedures be approved by the Licensing Committee.

(A) Such requests must be in writing and submitted to and approved by the Licensing Committee prior to the expiration of the annual period for which the alternative is being requested.

(B) A licensee must provide supporting documentation detailing the reason why the continuing education requirements set forth in this section cannot be met and must submit a proposal for alternative education procedures.

(C) Acceptable causes may include unanticipated financial or medical hardships or other extraordinary circumstances that are documented.

(D) A licensee who resides outside of the United States may, without prior approval of the Licensing Committee, complete all required hours of coursework by self-study.

(i) These self-study hours must be provided by those entities cited in §104.2 of this title (relating to Providers). Examples of self-study courses include correspondence courses, video courses, audio courses, and reading courses.

(ii) Upon being audited for continuing education compliance, a licensee who submits self-study hours under this subsection must be able to demonstrate residence outside of the United States for all periods of time for which self-study hours were submitted.

(E) Should a request to the Licensing Committee be denied, the licensee must complete the requirements of this section.

(2) Effective September 1, 2008, the following conditions and restrictions shall apply to coursework submitted for renewal purposes:

(A) At least 8 hours of coursework must be either technical or scientific as related to clinical care. The terms "technical" and "scientific" as applied to continuing education shall mean that courses have significant intellectual or practical content and are designed to directly enhance the practitioner's knowledge and skill in providing clinical care to the individual patient.

(B) Up to 4 hours of coursework may be in risk-management courses. Acceptable "risk management" courses include courses in risk management, record-keeping, and ethics.

(C) Up to 6 hours of coursework may be self-study. These self-study hours must be provided by those entities cited in §104.2 of this title (relating to Providers). Examples of self-study courses include correspondence courses, video courses, audio courses, and reading courses.

(D) Hours of coursework in the standards of the Occupational Safety and Health Administration (OSHA) annual update course or in cardiopulmonary resuscitation (CPR) basic life support training may not be considered in the 12-hour requirement.

(E) Hours of coursework in practice finance may not be considered in the 12-hour requirement.

(3) Each licensee shall complete [either] the jurisprudence assessment every three (3) years. This requirement is in addition to the twelve (12) hours of continuing education required annually for the renewal of a license.

(4) A licensee may carry forward continuing education hours earned prior to a renewal period which are in excess of the 12-hour requirement and such excess hours may be applied to subsequent years' requirements. Excess hours to be carried forward must have been earned in a classroom setting and within the three years immediately preceding the renewal period. A maximum of 24 total excess credit hours may be carried forward.

(5) Examiners for the Western Regional Examining Board (WREB) and for Central Regional Dental Testing Services Inc. (CRDTS) will be allowed credit for no more than 6 hours annually, obtained from [WREB's] calibration and standardization exercises associated with the examinations [exercise].

(6) Any individual or entity may petition one of the providers listed in §104.2 of this title to offer continuing education.

(7) Providers cited in §104.2 of this title will approve individual courses and/or instructors.

(8) A consultant for the SBDE who is also a licensee of the SBDE is eligible to receive up to 6 hours of continuing education credit annually to apply towards the annual renewal continuing education requirement under this section.

(A) Continuing education credit hours shall be awarded for the issuance of an expert opinion based upon the review of SBDE cases and for providing assistance to the SBDE in the investigation and prosecution of cases involving violations of the Dental Practice Act and/or the Rules of the SBDE.

(B) The amount of continuing education credit hours to be granted for each consultant task performed shall be determined by the Executive Director, Division Director or manager that authorizes the consultant task to be performed. The award of continuing education credit shall be confirmed in writing and based upon a reasonable assessment of the time required to complete the task.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703942

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


CHAPTER 107. DENTAL BOARD PROCEDURES

SUBCHAPTER B. COMPLAINTS AND INVESTIGATIONS

22 TAC §107.104

The State Board of Dental Examiners (Board) proposes an amendment to §107.104, concerning the Official Investigation of a Complaint. This amendment will modify the Board's complaint investigation process in accordance with changes made in SB 313.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to comply with changes made in SB 313. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed amendment may be submitted to Tyler Vance, Assistant General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The amendment is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§107.104.Official Investigation of a Complaint.

(a) Once an official investigation commences, board staff shall notify the complainant and respondent of the filing of the complaint and the commencing of the official investigation. The complainant and the respondent shall receive notice of the complaint's status, at least quarterly, until final disposition of the complaint, unless such notice would jeopardize an investigation.

(b) The official investigation of a complaint may include referral to a panel of experts for review.

(c) As of September 1, 2016, board staff shall classify each filed complaint into one or more of the following allegation categories:

(1) Standard of Care: failure to treat a patient according to the standard of care in the practice of dentistry or dental hygiene.

(2) Sanitation: failure to maintain the dental office in a sanitary condition.

(3) Dishonorable Conduct: unprofessional or dishonorable conduct, including conduct identified in §108.9 of this title (related to Dishonorable Conduct).

(4) Administrative: failure to comply with administrative requirements of the Act or board rules.

(5) Business Promotion: failure to comply with the requirements of the Act or board rules relating to advertising and referral schemes.

(6) Practicing Dentistry without a License.

(7) Non-compliance: failure to comply or timely comply with an Order or Remedial Plan issued by the board.

(d) Board staff shall assign each filed complaint a priority classification, as follows:

(1) Priority 1 includes allegations that [of dental treatment causing serious patient harm, impairment, serious criminal activity, inappropriate contact with a patient, and other allegations determined by the Director of Investigations to] require an expedited investigation or consideration of temporary suspension of license or permits. [pursuant to §263.004 of the Act.]

(2) Priority 2 includes [record-keeping violations, administrative violations, allegations of practicing dentistry without a license that do not allege serious patient harm, and other] allegations that require an expedited investigation. [do not allege serious patient harm.]

(3) Priority 3 includes investigations that require a standard investigation.

(4) [(3)] A complaint's priority classification may be changed when appropriate. [following approval of the Director of Investigation or the Dental Director.]

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703956

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


CHAPTER 110. SEDATION AND ANESTHESIA

22 TAC §110.7

The State Board of Dental Examiners (Board) proposes an amendment to §110.7, concerning Portability. The proposed amendment will eliminate the requirement for a portability permit and will require portable dentists to provide the physical addresses of the locations they practice at.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to gather more data on portability and to comply with the requirements of SB313. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed amendment may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The amendment is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§110.7.Portability.

(a) A dentist who applies for the issuance or renewal of a sedation/anesthesia permit must include in the application a statement indicating whether the dentist provides or will provide a permitted sedation/anesthesia service in more than one location and the physical address of each location at which the dentist provides or will provide permitted sedation/anesthesia services.

[(a) A sedation/anesthesia permit is valid for the dentist's facility, if any, as well as any satellite facility.]

[(b) A Texas licensed dentist who holds the Board-issued privilege of portability on or before June 1, 2011 will automatically continue to hold that privilege provided the dentist complies with the renewal requirements of this section.]

[(c) Portability of a sedation/anesthesia permit will be granted to a dentist who, after June 1, 2011, applies for portability, if the dentist:]

[(1) holds a Level 4 Deep Sedation/General Anesthesia permit;]

[(2) holds a Level 3 Moderate Parenteral Sedation permit and the permit was granted based on education received in conjunction with the completion of a oral and maxillofacial specialty education program or a dental anesthesia program; or]

[(3) holds a Level 3 Moderate Parenteral Sedation permit and if:]

[(A) the training for the permit was obtained on the basis of completion of any of the following American Dental Association (ADA) Commission on Dental Accreditation (CODA) recognized or approved programs:]

[(i) a specialty program;]

[(ii) a general practice residency;]

[(iii) an advanced education in general dentistry program; or]

[(iv) a continuing education program. Dentists seeking a portability privilege designation based on this method of education shall also successfully complete no less than sixty (60) hours of didactic instruction and manage no less than twenty (20) dental patients by the intravenous route of administration; and]

[(B) the applicant provides proof of administration of no less than thirty (30) cases of personal administration of Level 3 sedation on patients in a primary or satellite practice location within the six (6) month period preceding the application for portability, but following the issuance of the sedation permit. Acceptable documentation shall include, but not be limited to, patient records demonstrating the applicant's anesthetic technique, as well as provision of services by the applicant within the minimum standard of care.]

(b) [(d)] A dentist providing sedation/ anesthesia services in more than one location [utilizing a portability permit] remains responsible for providing these services in strict compliance with all applicable laws and rules. The dentist shall ascertain that the location is supplied, equipped, staffed, and maintained in a condition to support provision of sedation/ anesthesia services that meet the standard of care.

[(e) Any applicant whose request for portability status is not granted on the basis of the application will be provided an opportunity for hearing pursuant to Texas Government Code, Chapter 2001 et seq.]

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703944

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


22 TAC §110.8

The State Board of Dental Examiners (Board) proposes the repeal of §110.8, concerning Provisional Anesthesia and Portability Permits. This rule repeal will eliminate the provisional anesthesia and portable anesthesia permits.

Kelly Parker, Executive Director, has determined that for the first five-year period the repeal is in effect, there will not be any fiscal implications for state or local government as a result of repealing the rule.

Ms. Parker has also determined that for the first five-year period the rule is repealed, the public benefit anticipated as a result of administering this section will be to reduce the burden on Board staff and to comply with the requirements of SB313. Ms. Parker has determined that for the first five-year period the rule is repealed, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed rule repeal may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

This rule repeal is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposed rule repeal.

§110.8.Provisional Anesthesia and Portability Permits.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703945

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


22 TAC §110.13

The State Board of Dental Examiners (Board) proposes new §110.13, concerning Sedation and Anesthesia checklist. This new rule will establish the requirements of a preoperative checklist for all levels of sedation/anesthesia.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to increase safety to patients receiving sedation/anesthesia. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed new rule may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The new rule is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§110.13.Required Preoperative Checklist for Administration of Levels 1, 2, 3, and 4 Sedation/Anesthesia.

(a) A dentist administering level 1, 2, 3, or 4 sedation/anesthesia must create and maintain in the patient's dental records required by rule §108.8, a document titled "preoperative sedation/anesthesia checklist" that is completed by the dentist prior to commencing a procedure for which the dentist will administer Level 1, 2, 3, or 4 sedation/anesthesia.

(b) A dentist delegating the administration of sedation/anesthesia to another provider in accordance with §258.001(4) of the Act, must maintain in the patient's dental records required by rule §108.8, a document titled "preoperative sedation/anesthesia checklist" that is completed by the sedation/anesthesia provider prior to commencing a procedure for which the dentist has delegated another provider to administer the Level 1, 2, 3, or 4 sedation/anesthesia.

(c) The checklist must include, at a minimum, documentation of the following, or documentation of why the item was not recorded, for each level of sedation/anesthesia:

(1) Medical history, including documentation of the following:

(A) review of patient medical history;

(B) review of patient allergies;

(C) review of patient surgical and/or anesthesia history;

(D) review of family surgical and/or anesthesia history; and

(E) review of patient medications and date and time last taken

(2) Confirmation that written and verbal preoperative and post-operative instructions were delivered to the patient, parent, legal guardian, or care-giver;

(3) Medical consults, as needed;

(4) Physical examination, including documentation of the following:

(A) Body mass index;

(B) American Society of Anesthesiologists Physical Status Classification (ASA) classification;

(C) NPO status; and

(D) Preoperative vitals, including height, weight, blood pressure, pulse rate, and respiration rate;

(5) Anesthesia-specific physical examination including documentation of the following:

(A) Airway assessment, including Mallampati score and/or Brodsky score; and

(B) Auscultation;

(6) Confirmation of pre-procedure equipment readiness check;

(7) Confirmation of pre-procedure treatment review;

(8) Special preoperative considerations as indicated for sedation/anesthesia administered to pediatric or high risk patients; and

(9) Documentation of reason for omission of any item required by this subsection.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703953

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


22 TAC §110.14

The State Board of Dental Examiners (Board) proposes new §110.14, concerning Sedation and Anesthesia Emergency Preparedness. This new rule will establish the requirements of emergency preparedness policies and procedures related to sedation/anesthesia.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to increase safety in the administration of dental sedation/anesthesia. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed new rule may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The new rule is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§110.14.Emergency Preparedness Policies and Procedures.

(a) Pursuant to §258.1557 of the Act, a permit holder must develop written emergency preparedness policies and procedures, specific to the permit holder's practice setting, that establish a plan for the management of medical emergencies in each practice setting in which the dentist administers anesthesia.

(b) The emergency preparedness policies and procedures must include written protocols, policies, procedures, and training requirements, specific to the permit holder's equipment and drugs, for responding to emergency situations involving anesthesia, including information specific to respiratory emergencies.

(c) The permit holder must annually review the emergency preparedness policies and procedures to determine whether an update is necessary. The permit holder must maintain documentation of the dates of the emergency preparedness policies and procedures' creation, the most recent update, and the most recent annual review.

(d) Policies and procedures developed by all permit holders must include basic life support protocols, advanced cardiac life support rescue protocols, and/or pediatric advanced cardiac life support rescue protocols, consistent with the requirements of §§110.3, 110.4, 110.5 and 110.6, as applied to the permit holder.

(e) Policies and procedures developed by all permit holders must include, at a minimum, the following documents:

(1) Specific protocols for response to a sedation/anesthesia emergency, including specific protocols for response to a respiratory emergency and advanced airway management techniques;

(2) Staff training log, documenting staff training in emergency prevention, recognition, and response on at least an annual basis;

(3) Emergency drug log documenting monthly reviews for assurance of unexpired supply;

(4) Equipment readiness log indicating annual reviews for assurance of function of the equipment required by §110.15; and

(5) Individual office staff roles and responsibilities in response to an emergency, including roles and responsibilities specific to a response to a respiratory emergency.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703954

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


22 TAC §110.15

The State Board of Dental Examiners (Board) proposes new rule §110.15, concerning Sedation and Anesthesia Emergency Prevention and Response. This new rule will establish the requirements of emergency preparedness equipment and inspections related to sedation/anesthesia.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to increase safety to patients receiving sedation/anesthesia. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed new rule may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The new rule is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§110.15.Sedation and Anesthesia Emergency Prevention and Response.

(a) Pursuant to §258.1556 of the Act, the Board establishes minimum emergency preparedness standards and requirements for the administration of sedation/anesthesia.

(b) At any time a permit holder administers sedation/anesthesia, the permit holder must have immediately available:

(1) an adequate and unexpired supply of drugs and anesthetic agents, including, but not limited to:

(A) pharmacologic antagonists appropriate for sedation/anesthesia drugs used;

(B) vasopressors;

(C) corticosteroids;

(D) bronchodilators;

(E) antihistamines;

(F) antihypertensives;

(G) and anticonvulsants.

(2) an automated external defibrillator, as defined by §779.001 of the Texas Health and Safety Code;

(3) a positive pressure ventilation device;

(4) supplemental oxygen; and

(5) appropriate monitors and equipment, including, but not limited to:

(A) stethoscope;

(B) sphygmomanometer or automatic blood pressure monitor;

(C) pulse oximeter;

(D) an oxygen delivery system with adequate full face masks and appropriate connectors that is capable of delivering high flow oxygen to the patient under positive pressure, together with an adequate backup system;

(E) suction equipment which permits aspiration of the oral and pharyngeal cavities and a backup suction device which will function in the event of a general power failure;

(F) a lighting system which permits evaluation of the patient's skin and mucosal color and a backup lighting system of sufficient intensity to permit completion of any operation underway in the event of a general power failure; and

(G) precordial/pretracheal stethoscope, size-and-shape appropriate advanced airway device, intravenous fluid administration equipment, and /or electrocardiogram, consistent with the requirements of §§110.3, 110.4, 110.5. and 110.6, as applied to the permit holder.

(c) A permit holder who is administering sedation/anesthesia for which a Level 4 permit must use capnography during the administration of the sedation/anesthesia, as required by §258.1555 of the Act.

(d) Each permit holder must conduct an emergency drug inspection for assurance of unexpired supply at least monthly. Documentation of emergency drug inspections must be maintained in the permit holder's emergency drug log, required by §110.14.

(e) Each permit holder must conduct an equipment inspection for assurance of function at least annually. Documentation of equipment inspections must be maintained in the permit holder's equipment readiness log, required by §110.14.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703955

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


CHAPTER 111. STANDARDS FOR PRESCRIBING CONTROLLED SUBSTANCES AND DANGEROUS DRUGS

22 TAC §111.3

The State Board of Dental Examiners (Board) proposes new §111.3, concerning Prescription Monitoring by the Dentist. The proposed rule will require dentists to review a patient's prescription history prior to prescribing certain drugs.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to reduce prescription drug abuse and to comply with the requirements of the Texas Health and Safety Code. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed new rule may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The new rule is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§111.3.Prescription Monitoring by the Dentist.

(a) Beginning September 1, 2019, in accordance with Section 481.0764 of the Texas Health and Safety Code, a dentist shall access, review, and document the dentist's review of a patient's prescription drug history report through the Texas State Board of Pharmacy's Prescription Monitoring Program (PMP) Clearinghouse prior to prescribing or dispensing opioids, benzodiazepines, barbiturates, or carisoprodol to the dental patient, on or after September 1, 2019. Failure to access, review, and document the dentist's review is grounds for investigation by the Board.

(b) The act described above in subsection (a) of this section may be performed by an employee or other agent of the dentist acting at the direction of the dentist so long as that employee or agent acts in compliance with HIPAA and the employee or agent only accesses information related to a particular patient of the dentist. The dentist is responsible for any unauthorized access by an employee or other agent.

(c) Exceptions: the act described above in subsection (a) of this section is not required if the patient has been diagnosed with cancer or is receiving hospice care and that status is clearly noted in the patient's dental record.

(d) A dentist has complied with subsection (a) of this section if the dentist makes a good faith attempt to comply with subsection (a) of this section but is unable to do so due to circumstances outside the dentist's control, and those circumstances are clearly noted in the patient's dental record.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703946

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


22 TAC §111.4

The State Board of Dental Examiners (Board) proposes new §111.4, concerning Prescription Monitoring by the Board. The proposed rule will require the Board to review dentists' prescription history.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to reduce prescription drug abuse and diversion and to comply with the requirements of the Texas Health and Safety Code. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed new rule may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The new rule is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§111.4.Prescription Monitoring by the Board.

(a) The Board shall promulgate specific guidelines for dentists for the responsible prescribing of opioids, benzodiazepines, barbiturates, or carisoprodol.

(b) The Board shall periodically access a dentist's prescription information through the Texas State Board of Pharmacy's Prescription Monitoring Program to determine whether the dentist is engaging in potentially harmful prescribing patterns or practices. This determination will be based on:

(1) the number of times a dentist prescribes opioids, benzodiazepines, barbiturates, or carisoprodol; and

(2) patterns of prescribing combinations of those drugs and other dangerous combinations identified by the Texas State Board of Pharmacy.

(c) The Board shall notify a dentist if the agency discovers that the dentist may be engaging in potentially harmful prescribing patterns or practices.

(d) The Board may initiate an investigation of a dentist if the agency finds evidence during a periodic check that the dentist is engaging in conduct that violates any laws or rules related to the practice of dentistry.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703947

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


CHAPTER 114. EXTENSION OF DUTIES OF AUXILIARY PERSONNEL--DENTAL ASSISTANTS

22 TAC §114.1

The State Board of Dental Examiners (Board) proposes an amendment to §114.1, concerning the Permitted Duties of dental assistants. The proposed amendment establishes the requirements for a dental assistant to perform certain acts and will establish a deadline for scheduling a patient appointment following the interim care of a minor emergency condition.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to require training requirements for certain acts by dental assistants and to clarify the requirements associated with interim treatment of a minor emergency by a dental assistant. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed amendment may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The amendment is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§114.1.Permitted Duties.

(a) A dentist may delegate to a dental assistant the authority to perform only acts or procedures that are reversible. An act or procedure that is reversible is capable of being reversed or corrected.

(b) A dentist may not delegate or otherwise authorize a dental assistant to perform any task for which a certificate or additional training is required under this section, unless the dental assistant holds the required certificate or has obtained the additional training.

(c) A dental assistant may perform tasks under a dentist's general or direct supervision. For the purposes of this section:

(1) "General supervision" means that the dentist employs or is in charge of the dental assistant and is responsible for supervising the services to be performed by the dental assistant. The dentist may or may not be present on the premises when the dental assistant performs the procedures.

(2) "Direct supervision" means that the dentist employs or is in charge of the dental assistant and is physically present in the office when the task is performed. Physical presence does not require that the supervising dentist be in the treatment room when the dental assistant performs the service as long as the dentist is in the dental office.

(d) The dentist shall remain responsible for any delegated act.

(e) The clinical tasks that a dental assistant can perform under general supervision are limited to:

(1) the making of dental x-rays in compliance with the Occupations Code, §265.005; and

(2) the provision of interim treatment of a minor emergency dental condition to an existing patient of the treating dentist in accordance with the Occupations Code, §265.003(a-1). For purposes of this paragraph only, "existing patient" means a patient that the supervising dentist has examined in the twelve (12) months prior to the interim treatment. A treating dentist who delegates the provision of interim treatment of a minor emergency condition to a dental assistant shall schedule a follow-up appointment with the patient within 30 days. It is not a violation if the dentist makes a good faith attempt to schedule a follow-up appoint with the patient within 30 days but is unable to because circumstances outside the dentist's control and those circumstances are clearly noted in the patient's record.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703948

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


22 TAC §114.3

The State Board of Dental Examiners (Board) proposes an amendment to §114.3, concerning Pit and Fissure Sealants. This proposed amendment will eliminate the requirement that dental assistants be certified to perform pit and fissure sealants, but will maintain the education and training requirements.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to free Board staff from having to issue pit and fissure sealant certificates, in accordance with the recommendations of the Sunset Advisory Commission. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed new rule may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The amendment is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§114.3.Pit and Fissure Sealant [Certificate].

(a) The following words and terms, when used in this section, shall have the following meanings, unless the context clearly indicates otherwise:

(1) "Didactic education" requires the presentation and instruction of theory and scientific principles.

(2) "Clinical education" requires providing care to patient(s) under the direct supervision of a dentist or dental hygienist instructor.

(3) "Direct Supervision" requires that the instructor responsible for the procedure shall be physically present during patient care and shall be aware of the patient's physical status and well-being.

[(b) This subsection applies only to applications for certification received by the Board before September 1, 2009. A Texas-licensed dentist who is enrolled as a Medicaid Provider with appropriate state agencies, or who practices in an area determined to be underserved by the Department of State Health Services, may delegate the application of a pit and fissure sealant to a dental assistant, if the dental assistant:]

[(1) is employed by and works under the direct supervision of the licensed dentist; and]

[(2) is certified pursuant to subsection (f) of this section.]

[(c) This subsection applies only to applications for certification received by the Board on or after September 1, 2009. A Texas-licensed dentist may delegate the application of pit and fissure sealant to a dental assistant, if the dental assistant is certified pursuant to subsection (f) of this section.]

(b) [(d)] In addition to application of pit and fissure sealants a dental assistant who meets the requirements [certified] in this section may use a rubber prophylaxis cup and appropriate polishing materials to cleanse the occlusal and smooth surfaces of teeth that will be sealed or to prepare teeth for application of orthodontic bonding resins. Cleansing is intended only to prepare the teeth for the application of sealants or bonding resins and should not exceed the amount needed to do so.

(c) [(e)] The dentist may not bill for a cleansing provided hereunder as a prophylaxis.

(d) A Texas-licensed dentist may delegate the application of pit and fissure sealants to a dental assistant if the dental assist has:

(1) at least two years of experience as a dental assistant;

(2) successfully completed a current course in basic life support; and

(3) completed a minimum of 8 hours of education that includes clinical and didactic education in pit and fissure sealants taken through a CODA-accredited dental, dental hygiene, or dental assistant program approved by the Board whose course of instruction includes:

(A) infection control;

(B) cardiopulmonary resuscitation;

(C) treatment of medical emergencies;

(D) microbiology;

(E) chemistry;

(F) dental anatomy;

(G) ethics related to pit and fissure sealants;

(H) jurisprudence related to pit and fissure sealants; and

(I) the correct application of sealants, including the actual clinical application of sealants.

(e) Application of pit and fissure sealants must be in accordance with the minimum standard of care and limited to the dental assistant's scope of practice.

(f) The dental assistant must comply with the Dental Practice Act and Board Rules in the application of pit and fissure sealants. Pursuant to §258.003 of the Dental Practice Act, the delegating dentist is responsible for all dental acts delegated to a dental assistant, including application of pit and fissure sealant.

[(f) A dental assistant wishing to obtain certification under this section must:]

[(1) Pay an application fee set by board rule;]

[(2) And on a form prescribed by the Board provide proof that the applicant has:]

[(A) At least two years of experience as a dental assistant;]

[(B) Successfully completed a current course in basic life support; and]

[(C) Complete a minimum of 16 hours of education for certificates issued under applications received by the Board before September 1, 2009 or complete a minimum of 8 hours of education for certificates issued under applications received by the Board on or after September 1, 2009. To fulfill this requirement, the education must include clinical and didactic education in pit and fissure sealants taken through a CODA-accredited dental hygiene or dental assisting program approved by the Board whose course of instruction includes:]

[(i) infection control;]

[(ii) cardiopulmonary resuscitation;]

[(iii) treatment of medical emergencies;]

[(iv) microbiology;]

[(v) chemistry;]

[(vi) dental anatomy;]

[(vii) ethics related to pit and fissure sealants;]

[(viii) jurisprudence related to pit and fissure sealants; and]

[(ix) the correct application of sealants, including the actual clinical application of sealants.]

[(g) Before January 1 of each year, a dental assistant registered under this section who wishes to renew that registration must:]

[(1) Pay a renewal fee set by board rule; and]

[(2) Submit proof that the applicant has successfully completed a current course in basic life support; and either]

[(3) For certificates issued under applications filed before September 1, 2009, the dental assistant must complete at least six (6) hours of continuing education in technical and scientific coursework in the previous calendar year.]

[(A) The terms "technical" and "scientific", as applied to continuing education, shall mean that courses have significant intellectual or practical content and are designed to directly enhance the practitioner's knowledge and skill in providing clinical care to the individual patient.]

[(B) Dental assistants shall select and participate in continuing education courses offered by or endorsed by:]

[(i) dental schools, dental hygiene schools, or dental assisting schools that have been accredited by the Commission on Dental Accreditation of the American Dental Association; or,]

[(ii) nationally recognized dental, dental hygiene or dental assisting organizations.]

[(C) No more than three (3) hours of the required continuing education coursework may be in self-study; or]

[(4) For certificates issued under applications filed on or after September 1, 2009, the dental assistant must complete continuing education requirements in accordance with §114.12 of this chapter.]

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703950

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


22 TAC §114.5

The State Board of Dental Examiners (Board) proposes an amendment to §114.5, concerning Coronal Polishing by Dental Assistants. The proposed amendment will eliminate the requirement that dental assistants be certified to perform coronal polishing, but will maintain all other training requirements.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rule is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Ms. Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of administering this section will be to free Board staff from having to issue coronal polishing certificates in accordance with the recommendations of the Sunset Advisory Commission. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rule is enforced or administered.

Comments on the proposed amendment may be submitted to Tyler Vance, Assistant General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 463-7452, rulecomments@tsbde.texas.gov no later than 30 days from the date that the proposed rule is published in the Texas Register.

The amendment is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by this proposal.

§114.5.Coronal Polishing [Certificate].

(a) [The following term, when used in this section, shall have the following meaning, unless the context clearly indicates otherwise:] "Coronal polishing" means the removal of plaque and extrinsic stain from exposed natural and restored tooth surfaces using an appropriate rotary instrument with rubber cup or brush and polishing agent. This includes the use of a toothbrush.

(b) A Texas-licensed dentist may delegate coronal polishing to a dental assistant if the dental assistant:

(1) works under the direct supervision of the licensed dentist; and

(2) has at least two years experience as a dental assistant; and either [is certified pursuant to subsection (d) of this section.]

(A) has completed a minimum of eight (8) hours of clinical and didactic education in coronal polishing taken through a dental school, dental hygiene school, or dental assisting program accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the Board. The education must include courses on:

(i) oral anatomy and tooth morphology relating to retention of plaque and stain;

(ii) indications, contraindications, and complications of coronal polishing;

(iii) principles of coronal polishing, including armamentarium, operator and patient positioning, technique, and polishing agents;

(iv) infection control procedures;

(v) polishing coronal surfaces of teeth; and

(vi) jurisprudence relating to coronal polishing; or

(B) has either:

(i) graduated from a dental assisting program accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the board that includes specific didactic course work and clinical training in coronal polishing; or

(ii) received certification of completion of requirements specified by the Dental Assisting National Board and approved by the Board.

(c) The delegated duty of polishing by a dental assistant may not be billed as a prophylaxis.

(d) Coronal polishing must be in accordance with the minimum standard of care and limited to the dental assistant's scope of practice.

(e) The dental assistant must comply with the Dental Practice Act and Board Rules in the act of coronal polishing. Pursuant to §258.003 of the Dental Practice Act, the delegating dentist is responsible for all dental acts delegated to a dental assistant, including coronal polishing.

[(d) A dental assistant seeking certification under this section must:]

[(1) pay an application fee set by board rule; and]

[(2) on a form prescribed by the Board, provide proof that the applicant has:]

[(A) at least two years experience as a dental assistant; and either]

[(B) completed a minimum of eight (8) hours of clinical and didactic education in coronal polishing taken through a dental school, dental hygiene school, or dental assisting program accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the Board. The education must include courses on:]

[(i) oral anatomy and tooth morphology relating to retention of plaque and stain;]

[(ii) indications, contraindications, and complications of coronal polishing;]

[(iii) principles of coronal polishing, including armamentarium, operator and patient positioning, technique, and polishing agents;]

[(iv) infection control procedures;]

[(v) polishing coronal surfaces of teeth; and]

[(vi) jurisprudence relating to coronal polishing; or]

[(C) present proof to the Board that the assistant has either:]

[(i) graduated from a dental assisting program accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the board that includes specific didactic course work and clinical training in coronal polishing; or]

[(ii) received certification of completion of requirements specified by the Dental Assisting National Board and approved by the Board.]

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703951

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 475-0977


PART 21. TEXAS STATE BOARD OF EXAMINERS OF PSYCHOLOGISTS

CHAPTER 463. APPLICATIONS AND EXAMINATIONS

22 TAC §463.30

The Texas State Board of Examiners of Psychologists proposes an amendment to rule §463.30, Licensing for Military Service Members, Veterans and Spouses. The proposed amendment is necessary because the agency no longer has the resources needed to administer the oral examination. Without these changes, doctoral level applicants otherwise qualified for independent practice would be unable to achieve licensure as a psychologist.

FISCAL NOTE. Darrel D. Spinks, Executive Director of the Board, has determined that for the first five-year period the proposed amendment is in effect, there will be no additional estimated cost, reduction in costs, or loss or increase in revenue to the state or local governments as a result of enforcing or administering the rule as amended. Additionally, Mr. Spinks has determined that enforcing or administering the rule as amended, does not have foreseeable implications relating to the costs or revenues of state or local government.

PUBLIC BENEFIT. Mr. Spinks has determined for the first five-year period the proposed amendment is in effect, the public benefit anticipated as a result of enforcing the rule will be to help the Board protect the public.

PROBABLE ECONOMIC COSTS. Mr. Spinks has determined for the first five-year period the proposed amendment is in effect, the amended rule will not carry a economic cost to small businesses or local economies.

SMALL BUSINESS AND MICRO-BUSINESS IMPACT ANALYSIS. The proposed amendment will not have an adverse effect on small or micro-businesses.

LOCAL EMPLOYMENT IMPACT STATEMENT. The proposed amendment will not affect a local economy, thus a local employment impact statement is not required.

Comments on the proposed amendment may be submitted to Brenda Skiff, Public Information Officer, Texas State Board of Examiners of Psychologists, 333 Guadalupe, Ste. 2-450, Austin, Texas 78701, within 30 days of publication of this proposal in the Texas Register. Comments may also be submitted via fax to (512) 305-7701, or via email to Open.Records@tsbep.texas.gov.

The Board specifically invites comments from the public on the issues of whether or not the proposed amendment will have an adverse economic effect on small businesses; if the proposed rule is believed to have an adverse effect on small businesses, estimate the number of small businesses believed to be impacted by the rule, describe and estimate the economic impact of the rule on small businesses, offer alternative methods of achieving the purpose of the rule; then explain how the Board may legally and feasibly reduce that adverse effect on small businesses considering the purpose of the statute under which the proposed rule is to be adopted, finally describe how the health, safety, environmental and economic welfare of the state will be impacted by the various proposed methods. See §2006.002(c) and (c-1) of the Texas Government Code.

STATUTORY AUTHORITY. The amendment is proposed under Texas Occupations Code, Title 3, Subtitle I, Chapter 501, which provides the Texas State Board of Examiners of Psychologists with the authority to make all rules, not inconsistent with the Constitution and Laws of this State, which are reasonably necessary for the proper performance of its duties and regulations of proceedings before it.

No other code, articles or statutes are affected by this section.

§463.30.Licensing for Military Service Members, Veterans and Spouses.

(a) Military Service Members, Veterans and Spouses.

(1) A license may be issued to a military service member, military veteran, or military spouse, as those terms are defined by Chapter 55, Occupations Code, provided that the following documentation is provided to the Board:

(A) if the applicant is a military spouse, proof of marriage to a military service member; and

(B) proof that the applicant holds a current license in another jurisdiction that has licensing requirements that are substantially equivalent to the requirements for the license in this state; or

(C) proof that within the five years preceding the application date, the spouse held the license in Texas.

(2) An applicant applying for licensure under paragraph (1) of this subsection must provide documentation from all other jurisdictions in which the applicant is licensed that indicate that the applicant has received no disciplinary action from those jurisdictions regarding a mental health license.

(3) As part of the application process, the Executive Director may waive any prerequisite for obtaining a license under this rule, other than paragraph (1)(B) and (C) of this subsection and the jurisprudence examination, if it is determined that the applicant's education, training, and experience provide reasonable assurance that the applicant has the knowledge and skills necessary for entry-level practice under the license sought. When making this determination, the Executive Director must consult with the Board's Applications Committee and consider the committee's input and recommendations. In the event the Executive Director does not follow a recommendation of the Applications Committee, he or she must submit a written explanation to the Applications Committee explaining why its recommendation was not followed. No waiver may be granted where a military service member or military veteran holds a license issued by another jurisdiction that has been restricted, or where the applicant has an unacceptable criminal history.

(4) Alternative demonstrations of competency to meet the requirements for licensure. The following provisions provide alternative demonstrations of competency to the Board's licensing standards.

(A) Licensed Specialist in School Psychology. An applicant who meets the requirements of paragraph (1) of this subsection is considered to have met the following requirements for this type of license: submission of an official transcript, and evidence of the required coursework or National Association of School Psychologists certification, and passage of the National School Psychology Examination. All other requirements for licensure are still required.

(B) Licensed Psychological Associate. An applicant who meets the requirements of paragraph (1) of this subsection is considered to have met the following requirements for this type of license: submission of an official transcript, 450 internship hours, and passage of the Examination for Professional Practice in Psychology (EPPP) at the Texas cut-off. All other requirements for licensure are still required.

(C) Provisionally Licensed Psychologist. An applicant who meets the requirements of paragraph (1) of this subsection is considered to have met the following requirements for this type of license: submission of an official transcript, and passage of the EPPP at the Texas cut-off. All other requirements for licensure are still required.

(D) Licensed Psychologist. An applicant who meets the requirements of paragraph (1) of this subsection is considered to have met the following requirements for this type of license: two years of supervised experience. All other requirements for licensure, including the requirements of this paragraph, are still required.

(5) Determination of substantial equivalency for licensing requirements in another state. The applicant must provide to the Board proof that the state in which the applicant is licensed has standards for licensure that are substantially equivalent to the requirements of this Board for the applicable license type:

(A) Licensed Specialist in School Psychology.

(i) The completion of a training program in school psychology approved/accredited by the American Psychological Association or the National Association of School Psychologists or a master's degree in psychology with specific course work as set forth in Board rule §463.9 of this title (relating to Licensed Specialist in School Psychology); and

(ii) Passage of the National School Psychology Examination.

(B) Licensed Psychological Associate.

(i) Graduate degree that is primarily psychological in nature and consisting of at least 42 semester credit hours in total with at least 27 semester credit hours in psychology courses;

(ii) Passage of the EPPP at the Texas cut-off score; and

(iii) A minimum of 6 semester credit hours of practicum, internship, or experience in psychology, under the supervision of a licensed psychologist.

(C) Provisionally Licensed Psychologist.

(i) Doctoral degree in psychology; and

(ii) Passage of the EPPP at the Texas cut-off score.

(D) Licensed Psychologist.

(i) Doctoral degree in psychology;

(ii) Passage of the EPPP at the Texas cut-off score; and

(iii) Two years or a minimum of 3,000 hours of supervised experience under a licensed psychologist.[; and]

[(iv) Passage of an oral examination.]

(6) Renewal of License Issued to Military Service Members, Veterans, and Spouses. A license issued pursuant to this rule shall remain active until the last day of the licensee's birth month following a period of one year from the date of issuance of the license, at which time it will be subject to all renewal requirements.

(b) Applicants with Military Experience.

(1) A military service member or military veteran, as defined by Chapter 55, Occupations Code, shall receive credit toward the following licensing requirements for verified military service, training, or education:

(A) Licensed Specialist in School Psychology. A military service member or military veteran who was engaged in or who has been engaged in the delivery of psychological services within the military, for at least one year, is considered to have met the following requirements for this type of license: a practicum and 600 internship hours. All other requirements for licensure are still required.

(B) Licensed Psychological Associate. A military service member or military veteran who was engaged in or who has been engaged in the delivery of psychological services within the military, for at least one year, is considered to have met the following requirements for this type of license: 1,750 hours of supervised experience. All other requirements for licensure are still required.

(C) Licensed Psychologist. A military service member or military veteran who was engaged in or who has been engaged in the delivery of psychological services within the military, for at least one year following conferral of a doctoral degree, is considered to have met the following requirements for this type of license: one year or a minimum of 1,750 hours of supervised experience. All other requirements for licensure are still required.

(2) A military service member or military veteran may not receive credit toward licensing requirements due to military service, training, or education if they hold a license issued by another jurisdiction that has been restricted, or they have an unacceptable criminal history.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 26, 2017.

TRD-201703830

Darrel D. Spinks

Executive Director

Texas State Board of Examiners of Psychologists

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 305-7706


PART 39. TEXAS BOARD OF PROFESSIONAL GEOSCIENTISTS

CHAPTER 851. TEXAS BOARD OF PROFESSIONAL GEOSCIENTISTS LICENSING AND ENFORCEMENT RULES

SUBCHAPTER B. P.G. LICENSING, FIRM REGISTRATION, AND GIT CERTIFICATION

22 TAC §851.83

The Texas Board of Professional Geoscientists (TBPG) proposes a new rule concerning the licensure and regulation of Professional Geoscientists in Texas. TBPG proposes 22 TAC §851.83, concerning Certain Licensees Temporarily Exempt from Continuing Education Requirements, for those licensees residing in Governor-designated disaster affected counties.

BACKGROUND AND PURPOSE

A Proclamation by the Governor of the State of Texas dated September 20, 2017, declared a state of emergency for certain counties in Texas due to Hurricane Harvey. This proposed rule allows licensees to continue practicing geoscience without interruption during the weeks and months immediately following the hurricane. Allowing licensees to continue to practice geoscience without interruption will allow them to assist in recovery, environmental damage assessment, post-flood foundation-stability assessment, environmental remediation and subsurface assessments related to structural rebuilding efforts in affected counties, thereby helping to preserve the public health, safety, and welfare in those areas, which are in imminent peril as a result of structures that have been damaged and otherwise become structurally unsound.

SECTION SUMMARY

Proposed new rule, §851.83, entitled Certain Licensees Temporarily Exempt From Continuing Education Requirements, outlines the process and conditions the board will use to provide temporary exemption from the continuing education requirements for those licensees residing in Governor-designated disaster affected counties, thereby allowing those licensees to renew their license in a timely manner and remain in compliance with continuing education requirements as long as the license, registration, or certification is renewed on or before August 31, 2018. This rule is intended as a temporary rule that may not remain in effect for five years, notwithstanding the preparation of five-year fiscal note and analyses.

FISCAL NOTE

Charles Horton, Executive Director of the Texas Board of Professional Geoscientists, has determined that for each fiscal year of the first five years the section is in effect there is no cost to the state as a result of enforcing or administering the section as proposed.

SMALL, MICRO-BUSINESS, AND RURAL COMMUNITIES ECONOMIC IMPACT ANALYSIS

Mr. Horton has determined that the proposed rule will not have an adverse effect on small businesses, micro-businesses, or rural communities. Consequently, an economic impact statement or regulatory flexibility analysis is not required. There will be no anticipated economic cost to individuals who are required to comply with the proposed sections. There is no anticipated negative impact on state or local government.

PUBLIC BENEFIT

Mr. Horton has also determined that for each year of the first five years the section is in effect, the public will benefit from adoption of the section. The public benefit anticipated as a result of enforcing or administering the section is the uninterrupted availability of licensees to carry out public geoscience throughout the state, including areas impacted by Hurricane Harvey, and continuing the ability of the Board to effectively regulate the public practice of geoscience in Texas.

REGULATORY ANALYSIS OF MAJOR ENVIRONMENTAL RULES

The Board has determined that this proposal is not a "major environmental rule" as defined by Government Code, §2001.0225. "Major environmental rule" is defined to mean a rule the specific intent of which is to protect the environment or reduce risk to human health from environmental exposure and that may adversely affect, in a material way, the economy, a sector of the economy, productivity, competition, jobs, the environment or the public health and safety of a state or a sector of the state. Although Professional Geoscientists and Registered Geoscience Firms play a key role in environmental protection for the state of Texas, this proposal is not specifically intended to protect the environment nor reduce risks to human health from environmental exposure.

TAKINGS IMPACT ASSESSMENT

Mr. Horton has determined that the proposal does not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code, §2007.043.

PUBLIC COMMENT

Comments on the proposed new rule may be submitted in writing to Charles Horton, Executive Director, Texas Board of Professional Geoscientists, 333 Guadalupe Street, Tower I-530, Austin, Texas 78701 or by mail to P.O. Box 13225, Austin, Texas 78711 or by e-mail to chorton@tbpg.state.tx.us. Please indicate "Comments on Proposed Rules" in the subject line of all e-mails submitted. Please submit comments within 30 days following publication of the proposal in the TexasRegister.

This new rule is proposed under the Texas Geoscience Practice Act, Occupations Code §1002.151, which authorizes the Board to adopt and enforce all rules and regulations consistent with the Act as necessary for the performance of its duties, and the regulation of the practice of geoscience in this state; and Occupations Code §1002.154, which provides that Board shall enforce the Act.

The proposed new rule implements the Texas Occupations Code, §1002.151 and §1002.154.

§851.83.Certain Licensees Temporarily Exempt From Continuing Education Requirements.

(a) Continuing Education: A Professional Geoscientist or a Geoscientist-in-Training who resides in a Governor-designated disaster affected county is temporarily exempt from the continuing education requirement as long as the license or certification is renewed on or before August 31, 2018.

(b) A list of the Professional Geoscientists and Geoscientists-in-Training who are temporarily exempt from the continuing education requirements under this section shall be made available on the TBPG website in a searchable format for a period of time that the executive director determines is necessary.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 29, 2017.

TRD-201703933

Charles Horton

Executive Director

Texas Board of Professional Geoscientists

Earliest possible date of adoption: November 12, 2017

For further information, please call: (512) 936-4401