Amendment SA1-SSA2-SB70

SB70-SSA2-SA1,403,20 (bm) 1. Notwithstanding par. (b) 1. to 28., a dental therapist shall, except as provided in subd. 2., limit his or her practice of dental therapy to providing the services, treatments, and procedures covered by his or her dental therapy education program.

SB70-SSA2-SA1,403,25 2. If any service, treatment, or procedure under par. (b) 1. to 28. was not covered by a dental therapist's dental therapy education program, the dental therapist may provide that service, treatment, or procedure if the dental therapist has subsequently received additional dental therapy educational training to provide that service, treatment, or procedure.

SB70-SSA2-SA1,404,4 (c) 1. Except as provided in subd. 2., a dental therapist licensed under this chapter may provide dental therapy services in this state only under the direct supervision or indirect supervision of a qualifying dentist with whom the dental therapist has entered into a collaborative management agreement.

SB70-SSA2-SA1,404,9 2. a. Once a dental therapist licensed under this chapter has provided dental therapy services for at least 2,000 hours under direct supervision or indirect supervision, the dental therapist may provide dental therapy services in this state under the general supervision of a qualifying dentist with whom the dental therapist has entered into a collaborative management agreement.

SB70-SSA2-SA1,404,16 b. For purposes of the 2,000 hours requirement under subd. 2. a., hours may include hours of providing dental therapy services in this state under direct supervision or indirect supervision of a qualifying dentist as described in subd. 1. or hours of providing dental therapy services under direct supervision or indirect supervision while licensed as a dental therapist outside this state, but may not include any hours completed prior to graduating from the dental therapy education program.

SB70-SSA2-SA1,404,19 3. Notwithstanding subds. 1. and 2., the level of supervision for a dental therapist may be further limited under the terms of a collaborative management agreement under par. (d) 1. b.

SB70-SSA2-SA1,405,2 4. A supervising dentist shall accept responsibility for all services performed by a dental therapist pursuant to a collaborative management agreement. If services needed by a patient are beyond the dental therapist's scope of practice or authorization under the collaborative management agreement, the dental therapist shall, to the extent required under the collaborative management agreement, consult with the supervising dentist as needed to arrange for those services to be provided by a dentist or another qualified health care provider.

SB70-SSA2-SA1,405,6 (d) 1. Prior to providing any dental therapy services, a dental therapist shall enter into a written collaborative management agreement with a qualifying dentist who will serve as a supervising dentist under par. (c). The agreement must be signed by the dental therapist and the qualifying dentist and address all of the following:

SB70-SSA2-SA1,405,8 a. The practice settings where services may be provided and the patient populations that may be served.

SB70-SSA2-SA1,405,12 b. Consistent with and subject to pars. (bm) and (c), any conditions or limitations on the services that may be provided by the dental therapist, the level of supervision required, and any circumstances requiring consultation prior to performing services.

SB70-SSA2-SA1,405,13 c. Age-specific and procedure-specific practice protocols.

SB70-SSA2-SA1,405,14 d. Dental record-keeping procedures.

SB70-SSA2-SA1,405,15 e. Plans for managing dental or medical emergencies.

SB70-SSA2-SA1,405,17 f. A quality assurance plan for monitoring care provided by the dental therapist.

SB70-SSA2-SA1,405,18 g. Protocols for administering and dispensing medications.

SB70-SSA2-SA1,405,20 h. Criteria or protocols relating to the provision of care to patients with specific medical conditions, treatments, or medications.

SB70-SSA2-SA1,405,21 i. Policies relating to supervision of dental hygienists and other staff.

SB70-SSA2-SA1,405,24 j. A plan for the referral of patients to other dental or health care providers or clinics when services needed are beyond the scope of practice or authorization of the dental therapist.

SB70-SSA2-SA1,406,2 k. Whether and to what extent the dental therapist may perform services described in par. (b) 15.

SB70-SSA2-SA1,406,4 2. a. A collaborative management agreement shall be limited to covering one qualifying dentist and one dental therapist.

SB70-SSA2-SA1,406,6 b. A dental therapist may enter into multiple collaborative management agreements.

SB70-SSA2-SA1,406,8 c. No dentist may have collaborative management agreements with more than 4 dental therapists at any time.

SB70-SSA2-SA1,406,9 (e) A dental therapist shall at all times comply with at least one of the following:

SB70-SSA2-SA1,406,15 1. Limit his or her practice to practicing in one or more dental health shortage areas. If a dental therapist begins practicing in a dental health shortage area, and that area loses its designation as a dental health shortage area while the dental therapist continues to practice in that area, the dental therapist is considered to satisfy this subdivision as long as the dental therapist continues to practice in that area.

SB70-SSA2-SA1,406,17 2. Practice in one or more settings in which at least 50 percent of the total patient base of the dental therapist consists of patients who are any of the following:

SB70-SSA2-SA1,406,18 a. Medical Assistance patients.

SB70-SSA2-SA1,406,19 b. Uninsured patients.

SB70-SSA2-SA1,406,20 c. Patients receiving dental care at free and charitable clinics.

SB70-SSA2-SA1,406,21 d. Patients receiving dental care at federally qualified health centers.

SB70-SSA2-SA1,406,22 e. Patients who reside in long-term care facilities.

SB70-SSA2-SA1,406,23 f. Veterans.

SB70-SSA2-SA1,406,24 g. Patients who are members of a federally recognized Indian tribe or band.

SB70-SSA2-SA1,406,25 h. Patients receiving dental care at clinics or facilities located on tribal lands.

SB70-SSA2-SA1,407,2 i. Patients with medical disabilities or chronic conditions that create barriers of access to dental care.

SB70-SSA2-SA1,883 Section 883. 447.063 of the statutes is amended to read:

SB70-SSA2-SA1,407,9 447.063 Preservation and transfer of patient health care records. (1) A person who manages or controls a business that offers dental, dental therapy, or dental hygiene services, including management or control of a business through which the person allows another person to offer dental, dental therapy, or dental hygiene services, shall preserve patient health care records, as defined in s. 146.81 (4), for an amount of time determined by the examining board by rule.

SB70-SSA2-SA1,407,16 (2) A person who manages or controls a business that offers dental, dental therapy, or dental hygiene services, including management or control of a business through which the person allows another person to offer dental, dental therapy, or dental hygiene services, shall, upon request of a patient or person authorized by the patient, as defined in s. 146.81 (5), transfer the patient health care records, as defined in s. 146.81 (4), of the patient to another person that the patient or person authorized by the patient specifies to receive the patient health care records.

SB70-SSA2-SA1,884 Section 884. 447.065 of the statutes is amended to read:

SB70-SSA2-SA1,407,22 447.065 Delegation of remediable procedures and dental practices. (1) A dentist or dental therapist who is licensed to practice dentistry under this chapter may delegate to an individual who is not licensed under this chapter only the performance of remediable procedures, and only if all of the following conditions are met:

SB70-SSA2-SA1,407,24 (a) The unlicensed individual performs the remediable procedures in accordance with a treatment plan approved by the dentist or dental therapist.

SB70-SSA2-SA1,408,2 (b) The dentist or dental therapist is on the premises when the unlicensed individual performs the remediable procedures.

SB70-SSA2-SA1,408,4 (c) The unlicensed individual's performance of the remediable procedures is subject to inspection by the dentist or dental therapist.

SB70-SSA2-SA1,408,11 (2) Subject to the requirements under s. 447.06 (2), a dentist or dental therapist who is licensed to practice dentistry under this chapter may delegate to a dental hygienist who is licensed to practice dental hygiene under this chapter the performance of remediable procedures and the administration of oral systemic premedications, local anesthesia, nitrous oxide inhalation analgesia, and subgingival sustained release chemotherapeutic agents, to the extent the dentist or dental therapist has the authority to perform the activity personally.

SB70-SSA2-SA1,408,14 (3) A dentist or dental therapist who delegates to another individual the performance of any practice or remediable procedure is responsible for that individual's performance of that delegated practice or procedure.

SB70-SSA2-SA1,885 Section 885. 447.07 (1) of the statutes is amended to read:

SB70-SSA2-SA1,408,21 447.07 (1) The examining board may, without further notice or process, limit, suspend, or revoke the license or certificate of any dentist, dental therapist, or dental hygienist, or the registration of a mobile dentistry program registrant, who fails, within 60 days after the mailing of written notice to the dentist's, dental therapist's, dental hygienist's, or registrant's last-known address, to renew the license, certificate, or registration.

SB70-SSA2-SA1,886 Section 886. 447.07 (3) (intro.) of the statutes is amended to read:

SB70-SSA2-SA1,409,10 447.07 (3) (intro.) Subject to the rules promulgated under s. 440.03 (1), the examining board may make investigations and conduct hearings in regard to any alleged action of any dentist, dental therapist, dental hygienist, or expanded function dental auxiliary, of a mobile dentistry program registrant, or of any other person it has reason to believe is engaged in or has engaged in the practice of dentistry, dental therapy, or dental hygiene, or the operation of a mobile dentistry program, in this state, and may, on its own motion, or upon complaint in writing, reprimand any dentist, dental therapist, dental hygienist, or expanded function dental auxiliary who is licensed or certified under this chapter, or any mobile dentistry program registrant, or deny, limit, suspend, or revoke his or her license or certificate, or the registration of the mobile dentistry program registrant, if it finds that the dentist, dental therapist, dental hygienist, expanded function dental auxiliary, or mobile dentistry program registrant has done any of the following:

SB70-SSA2-SA1,887 Section 887. 447.07 (3) (e) to (h) of the statutes are amended to read:

SB70-SSA2-SA1,409,15 447.07 (3) (e) Subject to ss. 111.321, 111.322, and 111.335, been convicted of a crime, the circumstances of which substantially relate to the practice of dentistry, dental therapy, or dental hygiene, the practice of an expanded function dental auxiliary, or the operation of a mobile dentistry program.

SB70-SSA2-SA1,409,18 (f) Violated this chapter or any federal or state statute or rule that relates to the practice of dentistry, dental therapy, dental hygiene, or an expanded function dental auxiliary, or the operation of a mobile dentistry program.

SB70-SSA2-SA1,409,21 (g) Subject to ss. 111.321, 111.322 and 111.34, practiced dentistry , dental therapy, or dental hygiene or as an expanded function dental auxiliary while his or her ability was impaired by alcohol or other drugs.

SB70-SSA2-SA1,409,24 (h) Engaged in conduct that indicates a lack of knowledge of, an inability to apply or the negligent application of, principles or skills of dentistry , dental therapy, or dental hygiene or the practice of an expanded function dental auxiliary.

SB70-SSA2-SA1,888 Section 888. 447.40 (intro.) of the statutes is amended to read:

SB70-SSA2-SA1,410,8 447.40 Informed consent. (intro.) Any dentist or dental therapist who treats a patient shall inform the patient about the availability of reasonable alternate modes of treatment and about the benefits and risks of these treatments. The reasonable dentist standard is the standard for informing a patient under this section. The reasonable dentist standard requires disclosure only of information that a reasonable dentist would know and disclose under the circumstances. The dentist's or dental therapist's duty to inform the patient under this section does not require disclosure of any of the following:

SB70-SSA2-SA1,889 Section 889. 447.40 (6) of the statutes is amended to read:

SB70-SSA2-SA1,410,12 447.40 (6) Information about alternate modes of treatment for any condition the dentist or dental therapist has not included in his or her diagnosis, assessment, or treatment plan at the time the dentist or dental therapist informs the patient.

SB70-SSA2-SA1,890 Section 890. 448.03 (2) (a) of the statutes is amended to read:

SB70-SSA2-SA1,410,22 448.03 (2) (a) Any person lawfully practicing within the scope of a license, permit, registration, certificate, or certification granted to practice midwifery under subch. XIII of ch. 440, to practice professional or practical nursing or nurse-midwifery under ch. 441, to practice chiropractic under ch. 446, to practice dentistry, dental therapy, or dental hygiene or as an expanded function dental auxiliary under ch. 447, to practice optometry under ch. 449, to practice as a physician assistant under subch. IX, to practice acupuncture under ch. 451 or under any other statutory provision, to practice naturopathic medicine under ch. 466, or as otherwise provided by statute.

SB70-SSA2-SA1,233e Section 233e. 448.03 (2) (a) of the statutes, as affected by 2023 Wisconsin Act .... (this act), is amended to read:

SB70-SSA2-SA1,411,9 448.03 (2) (a) Any person lawfully practicing within the scope of a license, permit, registration, certificate, or certification granted to practice midwifery under subch. XIII of ch. 440, to practice professional or , practical, or advanced practice registered nursing or nurse-midwifery under ch. 441, to practice chiropractic under ch. 446, to practice dentistry, dental therapy, or dental hygiene or as an expanded function dental auxiliary under ch. 447, to practice optometry under ch. 449, to practice as a physician assistant under subch. IX, to practice acupuncture under ch. 451 or under any other statutory provision, to practice naturopathic medicine under ch. 466, or as otherwise provided by statute.

SB70-SSA2-SA1,891 Section 891. 448.03 (3m) of the statutes is created to read:

SB70-SSA2-SA1,411,23 448.03 (3m) Use of terms representing physicians. Except as otherwise provided in this chapter, no person, except a licensed physician, may use or assume the following words, letters, or terms in his or her title, advertising, or description of services: “physician,” “surgeon,” “osteopathic physician,” “osteopathic surgeon," “medical doctor," “anesthesiologist,” “cardiologist,” “ dermatologist,” “endocrinologist,” “gastroenterologist,” “gynecologist,” “hematologist,” “laryngologist,” “nephrologist,” “neurologist,” “ obstetrician,” “oncologist,” “ophthalmologist,” “orthopedic surgeon,” “orthopedist,” “osteopath,” “otologist,” “otolaryngologist,” “otorhinolaryngologist,” “pathologist,” “pediatrician,” “primary care physician,” “proctologist,” “psychiatrist,” “ radiologist,” “rheumatologist,” “rhinologist,” “urologist,” or any other words, letters, or abbreviations, alone or in combination with other titles or words, that represent or tend to represent that the person is a physician.

SB70-SSA2-SA1,892 Section 892. 448.035 (1) (a) of the statutes is repealed.

SB70-SSA2-SA1,893 Section 893. 448.035 (2) to (4) of the statutes are amended to read:

SB70-SSA2-SA1,412,13 448.035 (2) Notwithstanding the requirements of s. 448.30, a physician or certified advanced practice nurse prescriber may provide expedited partner therapy if the patient is diagnosed as infected with a chlamydial infection, gonorrhea, or trichomoniasis and the patient has had sexual contact with a sexual partner during which the chlamydial infection, gonorrhea, or trichomoniasis may have been transmitted to or from the sexual partner. The physician or certified advanced practice nurse prescriber shall attempt to obtain the name of the patient's sexual partner. A prescription order for an antimicrobial drug prepared under this subsection shall include the name and address of the patient's sexual partner, if known. If the physician or certified advanced practice nurse prescriber is unable to obtain the name of the patient's sexual partner, the prescription order shall include, in ordinary bold-faced capital letters, the words, “expedited partner therapy" or the letters “EPT."

SB70-SSA2-SA1,412,17 (3) The physician or certified advanced practice nurse prescriber shall provide the patient with a copy of the information sheet prepared by the department of health services under s. 46.03 (44) and shall request that the patient give the information sheet to the person with whom the patient had sexual contact.

SB70-SSA2-SA1,412,22 (4) (a) Except as provided in par. (b), a physician or certified advanced practice nurse prescriber is immune from civil liability for injury to or the death of a person who takes any antimicrobial drug if the antimicrobial drug is prescribed, dispensed, or furnished under this section and if expedited partner therapy is provided as specified under this section.

SB70-SSA2-SA1,413,2 (b) The immunity under par. (a) does not extend to the donation, distribution, furnishing, or dispensing of an antimicrobial drug by a physician or certified advanced practice nurse prescriber whose act or omission involves reckless, wanton, or intentional misconduct.

SB70-SSA2-SA1,894 Section 894. 448.07 (1) (a) of the statutes is amended to read:

SB70-SSA2-SA1,413,16 448.07 (1) (a) Every person licensed or certified under this subchapter shall register on or before November 1 of each odd-numbered year following issuance of the license or certificate with the board on or before his or her renewal date determined by the department under s. 440.08 (2). Registration shall be completed in such manner as the board shall designate and upon forms the board shall provide, except that registration with respect to a compact license shall be governed by the renewal provisions in s. 448.980 (7). The secretary of the board, on or before October 1 of each odd-numbered year, shall mail or cause to be mailed to every person required to register a registration form. The board shall furnish to each person registered under this section a certificate of registration, and the person shall display the registration certificate conspicuously in the office at all times. No person may exercise the rights or privileges conferred by any license or certificate granted by the board unless currently registered as required under this subsection.

SB70-SSA2-SA1,895 Section 895. 448.13 (title) of the statutes is repealed and recreated to read:

SB70-SSA2-SA1,413,18 448.13 (title) Continuing education and professional development.

SB70-SSA2-SA1,896 Section 896. 448.13 (1) (a) 1. of the statutes is amended to read:

SB70-SSA2-SA1,413,23 448.13 (1) (a) 1. Continuing education programs or courses of study approved for at least 30 hours of credit required by the board within the 2 calendar years preceding the calendar year for which the registration is effective by rule under s. 448.40 (2).

SB70-SSA2-SA1,897 Section 897. 448.13 (1) (a) 2. of the statutes is amended to read:

SB70-SSA2-SA1,414,4 448.13 (1) (a) 2. Professional development and maintenance of certification or performance improvement or continuing medical education programs or courses of study required by the board by rule under s. 448.40 (1) and completed within the 2 calendar years preceding the calendar year for which the registration is effective.

SB70-SSA2-SA1,898 Section 898. 448.13 (1m) of the statutes is amended to read:

SB70-SSA2-SA1,414,12 448.13 (1m) The board shall, on a random basis, verify the accuracy of proof submitted by physicians under sub. (1) (a) and may, at any time during the 2 calendar years specified in sub. (1) (a), require a physician to submit proof of any continuing education, professional development, and maintenance of certification or performance improvement or continuing medical education programs or courses of study that he or she has attended and completed at that time during the 2 calendar years since he or she last registered under s. 448.07.

SB70-SSA2-SA1,899 Section 899. 448.40 (1) of the statutes is amended to read:

SB70-SSA2-SA1,414,18 448.40 (1) The board may promulgate rules to carry out the purposes of this subchapter, including rules requiring the completion of continuing education, professional development, and maintenance of certification or performance improvement or continuing medical education programs for renewal of a license to practice medicine and surgery.

SB70-SSA2-SA1,900 Section 900. 448.40 (2) (e) of the statutes is amended to read:

SB70-SSA2-SA1,415,4 448.40 (2) (e) Establishing continuing education or continuing medical education requirements for renewal of a license to practice medicine and surgery under s. 448.13 (1). The board shall require 30 hours of continuing education to be completed every 2-year period. The examining board shall establish the criteria for the substitution of uncompensated hours of professional assistance volunteered to the department of health services for some or all of the hours of continuing education credits required under s. 448.13 (1) (a) 1. for physicians specializing in psychiatry. The eligible substitution hours shall involve professional evaluation of community programs for the certification and recertification of community mental health programs, as defined in s. 51.01 (3n), by the department of health services.

SB70-SSA2-SA1,901 Section 901. 448.55 (2) of the statutes is amended to read:

SB70-SSA2-SA1,415,12 448.55 (2) The renewal dates for licenses granted under this subchapter, other than temporary licenses granted under rules promulgated under s. 448.53 (2), are specified shall be as determined by the department under s. 440.08 (2) (a). Renewal applications shall be submitted to the department on a form provided by the department and shall include the renewal fee determined by the department under s. 440.03 (9) (a) and proof of compliance with the requirements established in any rules promulgated under sub. (3).

SB70-SSA2-SA1,902 Section 902. 448.56 (1) and (1m) (b) of the statutes are amended to read:

SB70-SSA2-SA1,416,3 448.56 (1) Written referral. Except as provided in this subsection and s. 448.52, a person may practice physical therapy only upon the written referral of a physician, naturopathic doctor, physician assistant, chiropractor, dentist, podiatrist, or advanced practice registered nurse prescriber certified under s. 441.16 (2). Written referral is not required if a physical therapist provides services in schools to children with disabilities, as defined in s. 115.76 (5), pursuant to rules promulgated by the department of public instruction; provides services as part of a home health care agency; provides services to a patient in a nursing home pursuant to the patient's plan of care; provides services related to athletic activities, conditioning, or injury prevention; or provides services to an individual for a previously diagnosed medical condition after informing the individual's physician, naturopathic doctor, physician assistant, chiropractor, dentist, podiatrist, or advanced practice registered nurse prescriber certified under s. 441.16 (2) who made the diagnosis. The examining board may promulgate rules establishing additional services that are excepted from the written referral requirements of this subsection.

SB70-SSA2-SA1,416,9 (1m) (b) The examining board shall promulgate rules establishing the requirements that a physical therapist must satisfy if a physician, naturopathic doctor, physician assistant, chiropractor, dentist, podiatrist, or advanced practice registered nurse prescriber makes a written referral under sub. (1). The purpose of the rules shall be to ensure continuity of care between the physical therapist and the health care practitioner.

SB70-SSA2-SA1,903 Section 903. 448.62 (2m) of the statutes is amended to read: