An Act concerning dentistry; concerning the dental practices act; dental services for dentally indigent persons; donated dental services program; retired licensees authorized to pro- vide charitable dental services; relating to the practice of dental hygienists; amending K.S.A. 65-1431, 65-1431, as amended by section 2 of 1996 House Bill No. 2813, and 65-1456 and repealing the existing sections; also repealing K.S.A. 65-1431, as amended by section 2 of this act.

Be it enacted by the Legislature of the State of Kansas:

New Section 1. (a) Notwithstanding any other provision of the dental practices act, a not-for-profit corporation having the status of an organi- zation under 26 United States Code Annotated 501(c)(3) which is also a facility qualified under subsection (b) of K.S.A. 65-431 and amendments thereto to select and employ professional personnel, an indigent health care clinic as defined by the rules and regulations of the secretary of health and environment, a federally qualified health center, or a local health department may employ or otherwise contract with a person li- censed under the dental practices act to provide dental services to dentally indigent persons.

(b) Dentally indigent persons are those persons who are: (1) Deter- mined to be a member of a family unit earning at or below 200% of poverty income guidelines based on the annual update of ``poverty income guidelines'' published in the federal register by the United States de- partment of health and human services and are not indemnified against costs arising from medical and hospital care or dental care by a policy of accident and sickness insurance or an employee health benefits plan; or (2) eligible for medicaid; or (3) qualified for Indian health services. This subsection shall not be construed to prohibit an entity under subsection (a) which enters into an arrangement with a licensee under the dental practices act for purposes of providing services to dentally indigent per- sons pursuant to subsection (a) from defining ``dentally indigent persons'' more restrictively than such term is defined under this subsection.

(c) A licensee under the dental practices act who enters into an ar- rangement with an entity under subsection (a) to provide dental services pursuant to subsection (a) shall not be subject to having the licensee's license certificate suspended or revoked by the board solely as a result of such arrangement.

(d) A dentist who is classified as ``retired'' by the Kansas dental board is not required to pay the annual renewal fee or comply with the dental continuing education requirements if the dentist elects to provide dental services to the indigent through one of the entities specified in subsection (a). A ``retired'' dentist providing such services shall be required to comply with the annual renewal requirements of the Kansas dental board.

(e) This section shall be part of and supplemental to the dental prac- tices act. The provisions of this section shall expire on July 1, 1998.

Sec. 2. K.S.A. 65-1431 is hereby amended to read as follows: 65- 1431. (a) On or before the first day of December of each year, each licensee of the Kansas dental board shall transmit to the secretary of the board, upon a form prescribed by the board, such licensee's signature, post-office address, office address, the number of the license certificate of such licensee, whether such licensee has been engaged during the preceding year in active and continuous practice, whether within or with- out this state, and such other information as may be required by the board, together with the annual registration fee for dentists which is fixed by the board pursuant to K.S.A. 65-1447 and amendments thereto.

(b) The board shall require every licensee to submit with the renewal application evidence of satisfactory completion of a program of continuing education required by the board. The board by duly adopted rules and regulations shall establish the requirements for such program of contin- uing education as soon as possible after the effective date of this act. In establishing such requirements the board shall consider any existing pro- grams of continuing education currently being offered to such licensees.

(c) Upon fixing the annual registration fee, the board shall immedi- ately notify all licensees of the amount of the fee for the ensuing year. Upon receipt of such fee and upon receipt of evidence that the licensee has satisfactorily completed a program of continuing education required by the board, the licensee shall be issued a renewal certificate authorizing the licensee to continue to practice in this state for a period of one year.

(d) Any license granted under authority of this act shall automatically be canceled if the holder thereof fails to secure a renewal certificate within a period of three months from November 30 of each year. Any licensee whose license is automatically canceled by reason of failure, ne- glect or refusal to secure the renewal certificate may be reinstated by the board at any time within three months from the date of the automatic cancellation of such license, upon payment of the annual registration fee and a penalty fee of $15 and upon proof that such licensee has satisfac- torily completed a program of continuing education required by the board. If such licensee has not applied for renewal of the license within three months after it has been automatically canceled and has not paid the required fees or presented proof of satisfactory completion of the required program of continuing education, then such licensee shall be required to file an application for and take the examination provided for in this act.

(e) Upon failure of any licensee to pay the annual registration fee or to present proof of satisfactory completion of the required program of continuing education within two months after November 30, the board shall notify such licensee, in writing, by mailing notice to such licensee's last registered address. Failure to mail or receive such notice shall not affect the cancellation of the license of such licensee.

(f) The board may waive the payment of annual fees and the contin- uing education requirements for the renewal of certificates without the payment of any registration fee for any person who has held a Kansas license to practice dentistry or dental hygiene if such licensee has retired from such practice or has become temporarily or permanently disabled and such licensee files with the board a certificate stating either of the following:

(1) A retiring licensee shall certify to the board that the licensee is: (A) At least 65 years of age and has retired from the active practice of dentistry or dental hygiene; and (B) not engaged, except as provided in section 1 and amendments thereto, in the provision of any dental service, the performance of any dental operation or procedure or the delivery of any dental hygiene service as defined by the statutes of the state of Kansas; or

(2) a disabled licensee shall certify to the board that such licensee is no longer engaged in the provision of dental services, the performance of any dental operation or the provision of any dental hygiene services as defined by the statutes of the state of Kansas by reason of any physical disability, whether permanent or temporary, and shall describe the nature of such disability.

(g) The waiver of fees under subsection (f) shall continue so long as the retirement or physical disability exists. Except as provided in section 1 and amendments thereto, in the event the licensee returns to the prac- tice for which such person is licensed, the requirement for payment of fees and continuing education requirements shall be reimposed com- mencing with and continuing after the date the licensee returns to such active practice. Except as provided in section 1 and amendments thereto, the performance of any dental service, including consulting service, or the performance of any dental hygiene service, including consulting serv- ice, shall be deemed the resumption of such service, requiring payment of license fees.

(h) The Kansas dental board may adopt such rules and regulations requiring the examination and providing means for examination of those persons returning to active practice after a period of retirement or disa- bility as the board shall deem necessary and appropriate for the protection of the people of the state of Kansas.

Sec. 3. On July 1, 1996, K.S.A. 65-1431, as amended by section 2 of 1996 House Bill No. 2813, is hereby amended to read as follows: 65-1431. (a) On or before December 1 of each even-numbered year, commencing December 1, 1996, each dentist licensee of the Kansas dental board shall transmit to the secretary of the board a renewal application, upon a form prescribed by the board, which shall include such licensee's signature, post-office address, office address, the number of the license certificate of such licensee, whether such licensee has been engaged during the preceding licensure period in active and continuous practice, whether within or without this state, and such other information as may be re- quired by the board, together with the biennial licensure fee for dentists which is fixed by the board pursuant to K.S.A. 65-1447 and amendments thereto.

(b) On or before December 1 of each odd-numbered year, com- mencing December 1, 1997, each dental hygiene licensee of the Kansas dental board shall transmit to the secretary of the board a renewal appli- cation, upon a form prescribed by the board, which shall include such licensee's signature, post office address, the number of the license cer- tificate of such licensee, whether such licensee has been engaged during the preceding licensure period in active and continuous practice whether within or without this state, and such other information as may be re- quired by the board, together with the biennial licensure fee for a dental hygienist which is fixed by the board pursuant to K.S.A. 65-1447 and amendments thereto. Each dental hygienist holding a license issued dur- ing the licensure period next preceding December 1, 1997, shall submit a renewal application on or before December 1, 1997, as provided in this section.

(c) The board shall require every licensee to submit with the renewal application evidence of satisfactory completion of a program of continuing education required by the board. The board by duly adopted rules and regulations shall establish the requirements for such program of contin- uing education as soon as possible after the effective date of this act. In establishing such requirements the board shall consider any existing pro- grams of continuing education currently being offered to such licensees.

(d) Upon fixing the biennial license renewal fee, the board shall im- mediately notify all licensees of the amount of the fee for the ensuing licensure period. Upon receipt of such fee and upon receipt of evidence that the licensee has satisfactorily completed a program of continuing education required by the board, the licensee shall be issued a renewal certificate authorizing the licensee to continue to practice in this state for a period of two years.

(e) (1) Any license granted under authority of this act shall automat- ically be canceled if the holder thereof fails to apply for renewal within a period of one month from December 1 of each year.

(2) Any licensee whose license is automatically canceled by reason of failure, neglect or refusal to secure the renewal certificate may be rein- stated by the board at any time within one month from the date of the automatic cancellation of such license, upon payment of the biennial re- newal fee and upon proof that such licensee has satisfactorily completed a program of continuing education required by the board or at any time within two months from the date of the automatic cancellation of the license upon payment of the biennial renewal fee and a penalty fee of $50 and upon proof that such licensee has satisfactorily completed a pro- gram of continuing education required by the board.

(f) Upon failure of any licensee to pay the applicable renewal fee or to present proof of satisfactory completion of the required program of continuing education within two months after November 30, the board shall notify such licensee, in writing, by mailing notice to such licensee's last registered address. Failure to mail or receive such notice shall not affect the cancellation of the license of such licensee.

(g) The board may waive the payment of biennial fees and the con- tinuing education requirements for the renewal of certificates without the payment of any fee for a person who has held a Kansas license to practice dentistry or dental hygiene if such licensee has retired from such practice or has become temporarily or permanently disabled and such licensee files with the board a certificate stating either of the following:

(1) A retiring licensee shall certify to the board that the licensee is: (A) At least 65 years of age and has retired from the active practice of dentistry or dental hygiene; and (B) not engaged, except as provided in section 1 and amendments thereto, in the provision of any dental service, the performance of any dental operation or procedure or the delivery of any dental hygiene service as defined by the statutes of the state of Kansas; or

(2) a disabled licensee shall certify to the board that such licensee is no longer engaged in the provision of dental services, the performance of any dental operation or the provision of any dental hygiene services as defined by the statutes of the state of Kansas by reason of any physical disability, whether permanent or temporary, and shall describe the nature of such disability.

(h) The waiver of fees under subsection (f) (g) shall continue so long as the retirement or physical disability exists. Except as provided in section 1 and amendments thereto, in the event the licensee returns to the prac- tice for which such person is licensed, the requirement for payment of fees and continuing education requirements shall be reimposed com- mencing with and continuing after the date the licensee returns to such active practice. Except as provided in section 1 and amendments thereto, the performance of any dental service, including consulting service, or the performance of any dental hygiene service, including consulting serv- ice, shall be deemed the resumption of such service, requiring payment of license fees.

(i) The Kansas dental board may adopt such rules and regulations requiring the examination and providing means for examination of those persons returning to active practice after a period of retirement or disa- bility as the board shall deem necessary and appropriate for the protection of the people of the state of Kansas.

Sec. 4. K.S.A. 65-1456 is hereby amended to read as follows: 65- 1456. (a) The board may suspend or revoke the license, license certificate and renewal certificate of any registered and licensed dentist who shall permit any dental hygienist operating under such dentist's supervision to perform any operation other than that permitted under the provisions of article 14 of chapter 65 of the Kansas Statutes Annotated, or acts amen- datory thereof, and may suspend or revoke the license of any hygienist found guilty of performing any operation other than those permitted un- der article 14 of chapter 65 of the Kansas Statutes Annotated, or acts amendatory thereof. No license or certificate of any dentist or dental hygienist shall be suspended or revoked in any administrative proceedings without first complying with the notice and hearing requirements of the Kansas administrative procedure act.

(b) The practice of dental hygiene shall include those educational, preventive, and therapeutic procedures which result in the removal of extraneous deposits, stains and debris from the teeth and the rendering of smooth surfaces of the teeth to the depths of the gingival sulci. In- cluded among those educational, preventive and therapeutic procedures are the instruction of the patient as to daily personal care, protecting the teeth from dental caries, the scaling and polishing of the crown surfaces and the planing of the root surfaces, in addition to the curettage of those soft tissues lining the free gingiva to the depth of the gingival sulcus and such additional educational, preventive and therapeutic procedures as the board may establish by rules and regulations.

(c) Subject to such prohibitions, limitations and conditions as the board may prescribe by rules and regulations, any licensed dental hy- gienist may practice dental hygiene and may also perform such dental service as may be performed by a dental assistant under the provisions of K.S.A. 65-1423 and amendments thereto.

(d) Except as otherwise provided in this section, the practice of dental hygiene shall be performed under the direct or indirect supervision of a licensed dentist at the office of such licensed dentist. The board may designate by rules and regulations the procedures which may be per- formed by a dental hygienist under direct supervision and the procedures which may be performed under the indirect supervision of a licensed dentist. As used in this section, ``indirect supervision'' means that the dentist is in the dental office, authorizes the procedures and remains in the dental office while the procedures are being performed and ``direct supervision'' means that the dentist is in the dental office, personally diagnoses the condition to be treated, personally authorizes the procedure and before dismissal of the patient evaluates the performance.

(e) The practice of dental hygiene may be performed at an adult care home, hospital long-term care unit, state institution, local health depart- ment or indigent health care clinic on a resident of a facility, client or patient thereof so long as:

(1) A licensed dentist has delegated the performance of the service, task or procedure;

(2) the dental hygienist is under the supervision and responsibility of the dentist;

(3) either the supervising dentist is personally present or the services, tasks and procedures are limited to the cleaning of teeth, education and preventive care;

(4) the supervising dentist examines the patient at the time the dental hygiene procedure is performed or has examined the patient during the 12 calendar months preceding performance of the procedure;

(5) nothing in this subsection (e) shall be construed to prevent a dental hygienist from providing dental education in a school setting; and

(6) the provisions of this subsection (e) shall expire on July 1, 1998.

(f) The board may issue a permit to a licensed dental hygienist to provide dental screening as an employee of the state of Kansas, or any subdivision thereof, at any public institution or facility under the super- vision of the governing body of such public institution or facility under such terms and conditions as the board may reasonably establish in such permit. Such permit shall be for a period of one year and shall be subject to renewal annually at the time the license for dental hygiene is renewed.

New Sec. 5. The secretary of social and rehabilitation services is hereby authorized in cooperation with the Kansas dental association and the national foundation of dentistry for the handicapped to establish a donated dental services program. The donated dental services program shall provide through volunteers who are licensed dentists comprehensive dental care without charge to needy, disabled, aged and medically-com- promised individuals. Volunteer licensed dentists will provide treatment under the donated dental services program in their respective offices or at the location at which the participating dentist agrees to provide the service. Patients will be treated under the program based upon arrange- ments as to the number of patients and the types of cases the participating volunteer dentists are willing to undertake. The secretary of social and rehabilitation services may adopt rules and regulations as necessary for the administration of this program.

Sec. 6. K.S.A. 65-1431 and 65-1456 are hereby repealed.

Sec. 7. On July 1, 1996, K.S.A. 65-1431, as amended by section 2 of this act, and 65-1431, as amended by section 2 of 1996 House Bill No. 2813, are hereby repealed.

Sec. 8. This act shall take effect and be in force from and after its publication in the Kansas register.

Approved May 11, 1996.

Published in the Kansas Register: May 23, 1996.