SB689,,33Analysis by the Legislative Reference Bureau This bill provides for the licensure of dental therapists, who are health care practitioners who may engage in the limited practice of dentistry.
Under current law, dentists and dental hygienists are licensed by the Dentistry Examining Board to practice dentistry and dental hygiene, respectively. This bill provides for the licensure of a third type of dental practitioner, dental therapists. Under the bill, the board must grant a dental therapist license to an individual who satisfies certain criteria, including completion of a qualifying dental therapy education program and passage of required examinations.
Under the bill, a dental therapy education program qualifies if the program 1) is accredited by the American Dental Association’s Commission on Dental Accreditation (CODA); 2) is a program approved by the Minnesota Board of Dentistry on or before the bill’s effective date that has, as of the time of application, become CODA-accredited; or 3) is a program offered in Wisconsin that has received initial CODA accreditation but is not yet fully CODA-accredited. With respect to the third category of dental therapy education programs (programs offered in Wisconsin), the bill allows applicants to obtain a license on the basis of graduation from such a program only for four years after the program’s inception, and if the program is not fully CODA-accredited by the time that four-year period has elapsed, the bill requires the licenses of dental therapists who graduated from the program to be revoked.
Under the bill, dental therapists may provide dental therapy services only as an employee of specified employers and only under the supervision of a dentist who is either similarly employed or who directly employs the dental therapist. The dental therapist must also have a collaborative management agreement with a dentist that addresses various aspects of the dental therapist’s practice and supervision. Dental therapists are, subject to the terms of a collaborative management agreement and what was covered in their dental therapy education program, limited to providing services, treatments, and procedures that are specified in the bill, as well as additional services, treatments, or procedures specified by the board by rule. Dental therapists may initially provide dental therapy services only under the direct or indirect supervision of a qualifying dentist. Once a dental therapist licensed has provided dental therapy services for at least 2,000 hours, the dental therapist may provide services under the general supervision of a qualifying dentist. However, the level of supervision for a dental therapist may be further limited under the terms of a collaborative management agreement. Dental therapists must also, under the bill, either 1) limit their practice to federally defined dental shortage areas or 2) practice in settings where at least 50 percent of their patient base consists of certain specified populations. Dental therapists must complete 12 hours of continuing education each biennium.
The bill subjects dental therapists to, or covers dental therapists under, various other laws, including the health care records law, the volunteer health care provider program, the health care worker protection law, and the emergency volunteer health care practitioner law. The bill also provides for loan forgiveness for dental therapists under the health care provider loan assistance program.
Finally, the bill requires, effective when 50 individuals become licensed as a dental therapist in this state or five years after the bill is enacted, that, to the extent possible, one of the dental hygienist members on the board also be licensed as a dental therapist.
For further information see the state fiscal estimate, which will be printed as an appendix to this bill.
SB689,,44The people of the state of Wisconsin, represented in senate and assembly, do enact as follows: SB689,15Section 1. 15.405 (6) (b) of the statutes is amended to read: SB689,,6615.405 (6) (b) Three dental hygienists who are licensed under ch. 447. The governor shall, to the extent possible, appoint members under this paragraph so that at least one of the members under this paragraph is an individual who is also a dental therapist licensed under ch. 447. Notwithstanding s. 15.08 (1m) (a), the dental hygienist members under this paragraph may participate in the preparation and grading of licensing examinations for dental hygienists. SB689,27Section 2. 36.61 (1) (ak) of the statutes is created to read: SB689,,8836.61 (1) (ak) “Dental therapist” means an individual licensed under s. 447.04 (1m). SB689,39Section 3. 36.61 (1) (b) of the statutes is amended to read: SB689,,101036.61 (1) (b) “Health care provider” means a dental therapist, dental hygienist, physician assistant, nurse-midwife, or nurse practitioner. SB689,411Section 4. 36.61 (3) (a) of the statutes is amended to read: SB689,,121236.61 (3) (a) The board shall enter into a written agreement with the health care provider. In the agreement, the health care provider shall agree to practice at least 32 clinic hours per week for 3 years in one or more eligible practice areas in this state or in a rural area, except that a health care provider in the expanded loan assistance program under sub. (8) who is not a dental therapist or dental hygienist may only agree to practice at a public or private nonprofit entity in a health professional shortage area. SB689,513Section 5. 36.61 (5) (b) 1. of the statutes is amended to read: SB689,,141436.61 (5) (b) 1. The degree to which there is an extremely high need for medical care in the eligible practice area, health professional shortage area, or rural area in which an eligible applicant who is not a dental therapist or dental hygienist desires to practice and the degree to which there is an extremely high need for dental care in the dental health shortage area or rural area in which an eligible applicant who is a dental therapist or dental hygienist desires to practice. SB689,615Section 6. 36.61 (8) (c) 3. of the statutes is amended to read: SB689,,161636.61 (8) (c) 3. Practice at a public or private nonprofit entity in a health professional shortage area, if the health care provider is not a dental therapist or dental hygienist, or in a dental health shortage area, if the health care provider is a dental therapist or dental hygienist. SB689,717Section 7. 146.81 (1) (c) of the statutes is amended to read: SB689,,1818146.81 (1) (c) A dentist or dental therapist licensed under ch. 447. SB689,819Section 8. 146.89 (1) (r) 1. of the statutes is amended to read: SB689,,2020146.89 (1) (r) 1. Licensed as a physician under ch. 448, naturopathic doctor under ch. 466, a dentist, dental therapist, or dental hygienist under ch. 447, a registered nurse, practical nurse, or nurse-midwife under ch. 441, an optometrist under ch. 449, a physician assistant under subch. IX of ch. 448, a pharmacist under ch. 450, a chiropractor under ch. 446, a podiatrist under subch. IV of ch. 448, or a physical therapist under subch. III of ch. 448. SB689,921Section 9. 146.89 (1) (r) 5. of the statutes is amended to read: SB689,,2222146.89 (1) (r) 5. An individual who holds a valid, unexpired license, certification, or registration issued by another state or territory that authorizes or qualifies the individual to perform acts that are substantially the same as those acts that an individual who is described in subds. 1. to 4., except a dentist, dental therapist, or dental hygienist, is licensed or certified to perform and who performs acts that are within the scope of that license, certification, or registration. SB689,1023Section 10. 146.89 (3) (b) 8. of the statutes is amended to read: