Sen. Bill Cunningham

Filed: 2/23/2023

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 1509

2    AMENDMENT NO. ______. Amend Senate Bill 1509 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Dental Practice Act is amended by
5changing Sections 4, 17, and 26 as follows:
 
6    (225 ILCS 25/4)   (from Ch. 111, par. 2304)
7    (Section scheduled to be repealed on January 1, 2026)
8    Sec. 4. Definitions. As used in this Act:
9    "Address of record" means the designated address recorded
10by the Department in the applicant's or licensee's application
11file or license file as maintained by the Department's
12licensure maintenance unit. It is the duty of the applicant or
13licensee to inform the Department of any change of address and
14those changes must be made either through the Department's
15website or by contacting the Department.
16    "Department" means the Department of Financial and

 

 

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1Professional Regulation.
2    "Secretary" means the Secretary of Financial and
3Professional Regulation.
4    "Board" means the Board of Dentistry.
5    "Dentist" means a person who has received a general
6license pursuant to paragraph (a) of Section 11 of this Act and
7who may perform any intraoral and extraoral procedure required
8in the practice of dentistry and to whom is reserved the
9responsibilities specified in Section 17.
10    "Dental hygienist" means a person who holds a license
11under this Act to perform dental services as authorized by
12Section 18.
13    "Dental assistant" means an appropriately trained person
14who, under the supervision of a dentist, provides dental
15services as authorized by Section 17.
16    "Expanded function dental assistant" means a dental
17assistant who has completed the training required by Section
1817.1 of this Act.
19    "Dental laboratory" means a person, firm or corporation
20which:
21        (i) engages in making, providing, repairing or
22    altering dental prosthetic appliances and other artificial
23    materials and devices which are returned to a dentist for
24    insertion into the human oral cavity or which come in
25    contact with its adjacent structures and tissues; and
26        (ii) utilizes or employs a dental technician to

 

 

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1    provide such services; and
2        (iii) performs such functions only for a dentist or
3    dentists.
4    "Supervision" means supervision of a dental hygienist or a
5dental assistant requiring that a dentist authorize the
6procedure, remain in the dental facility while the procedure
7is performed, and approve the work performed by the dental
8hygienist or dental assistant before dismissal of the patient,
9but does not mean that the dentist must be present at all times
10in the treatment room.
11    "General supervision" means supervision of a dental
12hygienist requiring that the patient be a patient of record,
13that the dentist examine the patient in accordance with
14Section 18 prior to treatment by the dental hygienist, and
15that the dentist authorize the procedures which are being
16carried out by a notation in the patient's record, but not
17requiring that a dentist be present when the authorized
18procedures are being performed. The issuance of a prescription
19to a dental laboratory by a dentist does not constitute
20general supervision.
21    "Public member" means a person who is not a health
22professional. For purposes of board membership, any person
23with a significant financial interest in a health service or
24profession is not a public member.
25    "Dentistry" means the healing art which is concerned with
26the examination, diagnosis, treatment planning and care of

 

 

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1conditions within the human oral cavity and its adjacent
2tissues and structures, as further specified in Section 17.
3    "Branches of dentistry" means the various specialties of
4dentistry which, for purposes of this Act, shall be limited to
5the following: endodontics, oral and maxillofacial surgery,
6orthodontics and dentofacial orthopedics, pediatric dentistry,
7periodontics, prosthodontics, oral and maxillofacial
8radiology, and dental anesthesiology.
9    "Specialist" means a dentist who has received a specialty
10license pursuant to Section 11(b).
11    "Dental technician" means a person who owns, operates, or
12is employed by a dental laboratory and engages in making,
13providing, repairing, or altering dental prosthetic appliances
14and other artificial materials and devices which are returned
15to a dentist for insertion into the human oral cavity or which
16come in contact with its adjacent structures and tissues.
17    "Informed consent" means the treating dentist has provided
18the patient with an opportunity to directly communicate with
19the treating dentist, whether in person, by telephone, or
20through synchronous technology, about the treatment to be
21provided.
22    "Impaired dentist" or "impaired dental hygienist" means a
23dentist or dental hygienist who is unable to practice with
24reasonable skill and safety because of a physical or mental
25disability as evidenced by a written determination or written
26consent based on clinical evidence, including deterioration

 

 

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1through the aging process, loss of motor skills, abuse of
2drugs or alcohol, or a psychiatric disorder, of sufficient
3degree to diminish the person's ability to deliver competent
4patient care.
5    "Nurse" means a registered professional nurse, a certified
6registered nurse anesthetist licensed as an advanced practice
7registered nurse, or a licensed practical nurse licensed under
8the Nurse Practice Act.
9    "Patient of record" means a patient for whom the patient's
10most recent dentist has obtained a relevant medical and dental
11history and on whom the dentist has performed an a physical
12examination within the last year and evaluated the condition
13to be treated, including a review of the patient's most recent
14x-rays.
15    "Dental responder" means a dentist or dental hygienist who
16is appropriately certified in disaster preparedness,
17immunizations, and dental humanitarian medical response
18consistent with the Society of Disaster Medicine and Public
19Health and training certified by the National Incident
20Management System or the National Disaster Life Support
21Foundation.
22    "Mobile dental van or portable dental unit" means any
23self-contained or portable dental unit in which dentistry is
24practiced that can be moved, towed, or transported from one
25location to another in order to establish a location where
26dental services can be provided.

 

 

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1    "Public health dental hygienist" means a hygienist who
2holds a valid license to practice in the State, has 2 years of
3full-time clinical experience or an equivalent of 4,000 hours
4of clinical experience, and has completed at least 42 clock
5hours of additional structured courses in dental education in
6advanced areas specific to public health dentistry.
7    "Public health setting" means a federally qualified health
8center; a federal, State, or local public health facility;
9Head Start; a special supplemental nutrition program for
10Women, Infants, and Children (WIC) facility; a certified
11school-based health center or school-based oral health
12program; a prison; or a long-term care facility.
13    "Public health supervision" means the supervision of a
14public health dental hygienist by a licensed dentist who has a
15written public health supervision agreement with that public
16health dental hygienist while working in an approved facility
17or program that allows the public health dental hygienist to
18treat patients, without a dentist first examining the patient
19and being present in the facility during treatment, (1) who
20are eligible for Medicaid or (2) who are uninsured and whose
21household income is not greater than 200% of the federal
22poverty level.
23    "Teledentistry" means the use of telehealth systems and
24methodologies in dentistry and includes patient diagnosis,
25treatment planning, care, and education delivery for a patient
26of record using synchronous and asynchronous communications

 

 

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1under an Illinois licensed a dentist's authority as provided
2under this Act.
3(Source: P.A. 101-64, eff. 7-12-19; 101-162, eff. 7-26-19;
4102-93, eff. 1-1-22; 102-588, eff. 8-20-21; 102-936, eff.
51-1-23.)
 
6    (225 ILCS 25/17)  (from Ch. 111, par. 2317)
7    (Section scheduled to be repealed on January 1, 2026)
8    Sec. 17. Acts constituting the practice of dentistry. A
9person practices dentistry, within the meaning of this Act:
10        (1) Who represents himself or herself as being able to
11    diagnose or diagnoses, treats, prescribes, or operates for
12    any disease, pain, deformity, deficiency, injury, or
13    physical condition of the human tooth, teeth, alveolar
14    process, gums, or jaw; or
15        (2) Who is a manager, proprietor, operator, or
16    conductor of a business where dental operations are
17    performed; or
18        (3) Who performs dental operations of any kind; or
19        (4) Who uses an X-Ray machine or X-Ray films for
20    dental diagnostic purposes; or
21        (5) Who extracts a human tooth or teeth, or corrects
22    or attempts to correct malpositions of the human teeth or
23    jaws; or
24        (6) Who offers or undertakes, by any means or method,
25    to diagnose, treat, or remove stains, calculus, and

 

 

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1    bonding materials from human teeth or jaws; or
2        (7) Who uses or administers local or general
3    anesthetics in the treatment of dental or oral diseases or
4    in any preparation incident to a dental operation of any
5    kind or character; or
6        (8) Who takes material or digital scans for final
7    impressions of the human tooth, teeth, or jaws or performs
8    any phase of any operation incident to the replacement of
9    a part of a tooth, a tooth, teeth, or associated tissues by
10    means of a filling, crown, a bridge, a denture, or other
11    appliance; or
12        (9) Who offers to furnish, supply, construct,
13    reproduce, or repair, or who furnishes, supplies,
14    constructs, reproduces, or repairs, prosthetic dentures,
15    bridges, or other substitutes for natural teeth, to the
16    user or prospective user thereof; or
17        (10) Who instructs students on clinical matters or
18    performs any clinical operation included in the curricula
19    of recognized dental schools and colleges; or
20        (11) Who takes material or digital scans for final
21    impressions of human teeth or places his or her hands in
22    the mouth of any person for the purpose of applying teeth
23    whitening materials, or who takes impressions of human
24    teeth or places his or her hands in the mouth of any person
25    for the purpose of assisting in the application of teeth
26    whitening materials. A person does not practice dentistry

 

 

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1    when he or she discloses to the consumer that he or she is
2    not licensed as a dentist under this Act and (i) discusses
3    the use of teeth whitening materials with a consumer
4    purchasing these materials; (ii) provides instruction on
5    the use of teeth whitening materials with a consumer
6    purchasing these materials; or (iii) provides appropriate
7    equipment on-site to the consumer for the consumer to
8    self-apply teeth whitening materials; or .
9        (12) Who uses teledentistry, a dentist may utilize and
10    delegate dental services using telehealth only under the
11    supervision requirements as specified in this Act for
12    in-person care. A dentist may only practice or utilize
13    teledentistry on a patient of record. A dentist practicing
14    dentistry through teledentistry is subject to the same
15    standard of care as if those services were being delivered
16    in a clinic or office setting. A patient receiving dental
17    services through teledentistry shall be provided with the
18    name, direct telephone number, and physical practice
19    address of the treating dentist who will be involved in
20    the teledentistry services. The information shall be
21    provided to the patient prior to the provision of
22    services. Prior to providing teledentistry services to a
23    patient, a dentist must obtain informed consent from the
24    patient, as defined in Section 4 of this Act, as to the
25    treatment proposed to be offered through teledentistry by
26    the dentist. The Department may adopt rules to implement

 

 

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1    this paragraph.
2    The fact that any person engages in or performs, or offers
3to engage in or perform, any of the practices, acts, or
4operations set forth in this Section, shall be prima facie
5evidence that such person is engaged in the practice of
6dentistry.
7    The following practices, acts, and operations, however,
8are exempt from the operation of this Act:
9        (a) The rendering of dental relief in emergency cases
10    in the practice of his or her profession by a physician or
11    surgeon, licensed as such under the laws of this State,
12    unless he or she undertakes to reproduce or reproduces
13    lost parts of the human teeth in the mouth or to restore or
14    replace lost or missing teeth in the mouth; or
15        (b) The practice of dentistry in the discharge of
16    their official duties by dentists in any branch of the
17    Armed Services of the United States, the United States
18    Public Health Service, or the United States Veterans
19    Administration; or
20        (c) The practice of dentistry by students in their
21    course of study in dental schools or colleges approved by
22    the Department, when acting under the direction and
23    supervision of dentists acting as instructors; or
24        (d) The practice of dentistry by clinical instructors
25    in the course of their teaching duties in dental schools
26    or colleges approved by the Department:

 

 

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1            (i) when acting under the direction and
2        supervision of dentists, provided that such clinical
3        instructors have instructed continuously in this State
4        since January 1, 1986; or
5            (ii) when holding the rank of full professor at
6        such approved dental school or college and possessing
7        a current valid license or authorization to practice
8        dentistry in another country; or
9        (e) The practice of dentistry by licensed dentists of
10    other states or countries at meetings of the Illinois
11    State Dental Society or component parts thereof, alumni
12    meetings of dental colleges, or any other like dental
13    organizations, while appearing as clinicians; or
14        (f) The use of X-Ray machines for exposing X-Ray films
15    of dental or oral tissues by dental hygienists or dental
16    assistants; or
17        (g) The performance of any dental service by a dental
18    assistant, if such service is performed under the
19    supervision and full responsibility of a dentist. In
20    addition, after being authorized by a dentist, a dental
21    assistant may, for the purpose of eliminating pain or
22    discomfort, remove loose, broken, or irritating
23    orthodontic appliances on a patient of record.
24        For purposes of this paragraph (g), "dental service"
25    is defined to mean any intraoral procedure or act which
26    shall be prescribed by rule or regulation of the

 

 

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1    Department. Dental service, however, shall not include:
2            (1) Any and all diagnosis of or prescription for
3        treatment of disease, pain, deformity, deficiency,
4        injury, or physical condition of the human teeth or
5        jaws, or adjacent structures.
6            (2) Removal of, or restoration of, or addition to
7        the hard or soft tissues of the oral cavity, except for
8        the placing, carving, and finishing of amalgam
9        restorations and placing, packing, and finishing
10        composite restorations by dental assistants who have
11        had additional formal education and certification.
12            A dental assistant may place, carve, and finish
13        amalgam restorations, place, pack, and finish
14        composite restorations, and place interim restorations
15        if he or she (A) has successfully completed a
16        structured training program as described in item (2)
17        of subsection (g) provided by an educational
18        institution accredited by the Commission on Dental
19        Accreditation, such as a dental school or dental
20        hygiene or dental assistant program, or (B) has at
21        least 4,000 hours of direct clinical patient care
22        experience and has successfully completed a structured
23        training program as described in item (2) of
24        subsection (g) provided by a statewide dental
25        association, approved by the Department to provide
26        continuing education, that has developed and conducted

 

 

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1        training programs for expanded functions for dental
2        assistants or hygienists. The training program must:
3        (i) include a minimum of 16 hours of didactic study and
4        14 hours of clinical manikin instruction; all training
5        programs shall include areas of study in nomenclature,
6        caries classifications, oral anatomy, periodontium,
7        basic occlusion, instrumentations, pulp protection
8        liners and bases, dental materials, matrix and wedge
9        techniques, amalgam placement and carving, rubber dam
10        clamp placement, and rubber dam placement and removal;
11        (ii) include an outcome assessment examination that
12        demonstrates competency; (iii) require the supervising
13        dentist to observe and approve the completion of 8
14        amalgam or composite restorations; and (iv) issue a
15        certificate of completion of the training program,
16        which must be kept on file at the dental office and be
17        made available to the Department upon request. A
18        dental assistant must have successfully completed an
19        approved coronal polishing and dental sealant course
20        prior to taking the amalgam and composite restoration
21        course.
22            A dentist utilizing dental assistants shall not
23        supervise more than 4 dental assistants at any one
24        time for placing, carving, and finishing of amalgam
25        restorations or for placing, packing, and finishing
26        composite restorations.

 

 

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1            (3) Any and all correction of malformation of
2        teeth or of the jaws.
3            (4) Administration of anesthetics, except for
4        monitoring of nitrous oxide, conscious sedation, deep
5        sedation, and general anesthetic as provided in
6        Section 8.1 of this Act, that may be performed only
7        after successful completion of a training program
8        approved by the Department. A dentist utilizing dental
9        assistants shall not supervise more than 4 dental
10        assistants at any one time for the monitoring of
11        nitrous oxide.
12            (5) Removal of calculus from human teeth.
13            (6) Taking of material or digital scans for final
14        impressions for the fabrication of prosthetic
15        appliances, crowns, bridges, inlays, onlays, or other
16        restorative or replacement dentistry.
17            (7) The operative procedure of dental hygiene
18        consisting of oral prophylactic procedures, except for
19        coronal polishing and pit and fissure sealants, which
20        may be performed by a dental assistant who has
21        successfully completed a training program approved by
22        the Department. Dental assistants may perform coronal
23        polishing under the following circumstances: (i) the
24        coronal polishing shall be limited to polishing the
25        clinical crown of the tooth and existing restorations,
26        supragingivally; (ii) the dental assistant performing

 

 

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1        the coronal polishing shall be limited to the use of
2        rotary instruments using a rubber cup or brush
3        polishing method (air polishing is not permitted); and
4        (iii) the supervising dentist shall not supervise more
5        than 4 dental assistants at any one time for the task
6        of coronal polishing or pit and fissure sealants.
7            In addition to coronal polishing and pit and
8        fissure sealants as described in this item (7), a
9        dental assistant who has at least 2,000 hours of
10        direct clinical patient care experience and who has
11        successfully completed a structured training program
12        provided by (1) an educational institution including,
13        but not limited to, a dental school or dental hygiene
14        or dental assistant program, or (2) a continuing
15        education provider approved by the Department, or (3)
16        a statewide dental or dental hygienist association,
17        approved by the Department on or before January 1,
18        2017 (the effective date of Public Act 99-680), that
19        has developed and conducted a training program for
20        expanded functions for dental assistants or hygienists
21        may perform: (A) coronal scaling above the gum line,
22        supragingivally, on the clinical crown of the tooth
23        only on patients 17 years of age or younger who have an
24        absence of periodontal disease and who are not
25        medically compromised or individuals with special
26        needs and (B) intracoronal temporization of a tooth.

 

 

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1        The training program must: (I) include a minimum of 32
2        hours of instruction in both didactic and clinical
3        manikin or human subject instruction; all training
4        programs shall include areas of study in dental
5        anatomy, public health dentistry, medical history,
6        dental emergencies, and managing the pediatric
7        patient; (II) include an outcome assessment
8        examination that demonstrates competency; (III)
9        require the supervising dentist to observe and approve
10        the completion of 6 full mouth supragingival scaling
11        procedures unless the training was received as part of
12        a Commission on Dental Accreditation approved dental
13        assistant program; and (IV) issue a certificate of
14        completion of the training program, which must be kept
15        on file at the dental office and be made available to
16        the Department upon request. A dental assistant must
17        have successfully completed an approved coronal
18        polishing course prior to taking the coronal scaling
19        course. A dental assistant performing these functions
20        shall be limited to the use of hand instruments only.
21        In addition, coronal scaling as described in this
22        paragraph shall only be utilized on patients who are
23        eligible for Medicaid, who are uninsured, or whose
24        household income is not greater than 300% of the
25        federal poverty level. A dentist may not supervise
26        more than 2 dental assistants at any one time for the

 

 

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1        task of coronal scaling. This paragraph is inoperative
2        on and after January 1, 2026.
3        The limitations on the number of dental assistants a
4    dentist may supervise contained in items (2), (4), and (7)
5    of this paragraph (g) mean a limit of 4 total dental
6    assistants or dental hygienists doing expanded functions
7    covered by these Sections being supervised by one dentist;
8    or
9        (h) The practice of dentistry by an individual who:
10            (i) has applied in writing to the Department, in
11        form and substance satisfactory to the Department, for
12        a general dental license and has complied with all
13        provisions of Section 9 of this Act, except for the
14        passage of the examination specified in subsection (e)
15        of Section 9 of this Act; or
16            (ii) has applied in writing to the Department, in
17        form and substance satisfactory to the Department, for
18        a temporary dental license and has complied with all
19        provisions of subsection (c) of Section 11 of this
20        Act; and
21            (iii) has been accepted or appointed for specialty
22        or residency training by a hospital situated in this
23        State; or
24            (iv) has been accepted or appointed for specialty
25        training in an approved dental program situated in
26        this State; or

 

 

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1            (v) has been accepted or appointed for specialty
2        training in a dental public health agency situated in
3        this State.
4        The applicant shall be permitted to practice dentistry
5    for a period of 3 months from the starting date of the
6    program, unless authorized in writing by the Department to
7    continue such practice for a period specified in writing
8    by the Department.
9        The applicant shall only be entitled to perform such
10    acts as may be prescribed by and incidental to his or her
11    program of residency or specialty training and shall not
12    otherwise engage in the practice of dentistry in this
13    State.
14        The authority to practice shall terminate immediately
15    upon:
16            (1) the decision of the Department that the
17        applicant has failed the examination; or
18            (2) denial of licensure by the Department; or
19            (3) withdrawal of the application.
20(Source: P.A. 101-162, eff. 7-26-19; 102-558, eff. 8-20-21;
21102-936, eff. 1-1-23.)
 
22    (225 ILCS 25/26)  (from Ch. 111, par. 2326)
23    (Section scheduled to be repealed on January 1, 2026)
24    Sec. 26. Disciplinary actions.
25    (a) In case the respondent, after receiving notice, fails

 

 

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1to file an answer, his or her license may, in the discretion of
2the Secretary, having first received the recommendation of the
3Board, be suspended, revoked, placed on probationary status,
4or the Secretary may take whatever disciplinary or
5non-disciplinary action he or she may deem proper, including
6limiting the scope, nature, or extent of the person's practice
7or the imposition of a fine, without a hearing, if the act or
8acts charged constitute sufficient grounds for such action
9under this Act.
10    (b) The Secretary may temporarily suspend the license of a
11dentist or dental hygienist without a hearing, simultaneous to
12the institution of proceedings for a hearing under this Act,
13if the Secretary finds that evidence in his or her possession
14indicates that a dentist's or dental hygienist's continuation
15in practice would constitute an immediate danger to the
16public. In the event that the Secretary temporarily suspends
17the license of a dentist or a dental hygienist without a
18hearing, a hearing by the Board must be held within 15 days
19after such suspension has occurred.
20    (c) The entry of a judgment by any circuit court
21establishing that any person holding a license under this Act
22is a person subject to involuntary admission under the Mental
23Health and Developmental Disabilities Code shall operate as a
24suspension of that license. That person may resume his or her
25practice only upon a finding by the Board that he or she has
26been determined to be no longer subject to involuntary

 

 

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1admission by the court and upon the Board's recommendation to
2the Secretary that he or she be permitted to resume his or her
3practice.
4    (d) It shall be a violation of this Act for a provider of
5dental services utilizing care through teledentistry to
6require a patient to sign an agreement that limits in any way
7the patient's ability to write a review of services received
8or file a complaint with the Department or other regulatory
9agency.
10(Source: P.A. 99-492, eff. 12-31-15.)".