88R11438 JCG-F     By: Klick H.B. No. 3824       A BILL TO BE ENTITLED   AN ACT   relating to the administration of a local anesthetic agent by a   dental hygienist.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 258.001, Occupations Code, is amended to   read as follows:          Sec. 258.001.  IMPERMISSIBLE DELEGATIONS. A dentist may not   delegate:                (1)  an act to an individual who, by board order, is   prohibited from performing the act;                (2)  any of the following acts to a person not licensed   as a dentist or dental hygienist:                      (A)  the removal of calculus, deposits, or   accretions from the natural and restored surfaces of exposed human   teeth and restorations in the human mouth;                      (B)  root planing or the smoothing and polishing   of roughened root surfaces or exposed human teeth; or                      (C)  any other act the delegation of which is   prohibited by board rule;                (3)  any of the following acts to a person not licensed   as a dentist:                      (A)  comprehensive examination or diagnosis and   treatment planning;                      (B)  a surgical or cutting procedure on hard or   soft tissue;                      (C)  the prescription of a drug, medication, or   work authorization;                      (D)  the taking of an impression for a final   restoration, appliance, or prosthesis;                      (E)  the making of an intraoral occlusal   adjustment;                      (F)  direct pulp capping, pulpotomy, or any other   endodontic procedure;                      (G)  the final placement and intraoral adjustment   of a fixed or removable appliance; or                      (H)  the placement of any final restoration; [or]                (4)  the authority to an individual to administer a   local anesthetic agent, inhalation sedative agent, parenteral   sedative agent, or general anesthetic agent, including as a   teledentistry dental service as that term is defined by Section   111.001, if the individual is not licensed as:                      (A)  a dentist with a permit issued by the board   for the procedure being performed, if a permit is required;                      (B)  a certified registered nurse anesthetist   licensed by the Texas Board of Nursing, only if the delegating   dentist holds a permit issued by the board for the procedure being   performed, if a permit is required; or                      (C)  a physician anesthesiologist licensed by the   Texas Medical Board; or                (5)  the authority to a dental hygienist to administer   a local anesthetic agent unless:                       (A)  the dental hygienist:                            (i)  administers the local anesthetic agent   by infiltration for purposes of a procedure the dental hygienist is   authorized to perform;                             (ii)  has passed a board-approved   certification examination relating to the administration of a local   anesthetic agent;                            (iii)  either:                                   (a)  has completed a board-approved   course of study designed to train dental hygienists to administer a   local anesthetic agent by infiltration that consists of at least 40   hours of didactic education and 30 hours of clinical education; or                                  (b)  during the preceding year, was   authorized to administer a local anesthetic agent by:                                         (1)  a branch of the United States   armed forces; or                                        (2)  another state with clinical   and didactic education requirements substantially equivalent to   the requirements of a course approved by the board under   Sub-subparagraph (a); and                            (iv)  complies with any applicable rules   adopted by the board establishing minimum standards for the   administration of a local anesthetic agent;                      (B)  the delegating dentist is physically present   in the facility where the procedure is occurring and is   continuously aware of the patient's physical status and well-being;   and                      (C)  the patient to whom the local anesthetic   agent is administered is:                            (i)  at least 18 years of age; and                             (ii)  not sedated, or is sedated using only   nitrous oxide-oxygen inhalation.          SECTION 2.  Section 262.002(a), Occupations Code, is amended   to read as follows:          (a)  A person practices dental hygiene if the person:                (1)  removes accumulated matter, tartar, deposits,   accretions, or stains, other than mottled enamel stains, from the   natural and restored surface of exposed human teeth and   restorations in the human mouth;                (2)  smoothes roughened root surfaces;                (3)  polishes exposed human teeth, restorations in the   human mouth, or roughened root surfaces;                (4)  topically applies drugs to the surface tissues of   the human mouth or the exposed surface of human teeth;                (5)  makes dental x-rays; [and]                (6)  administers a local anesthetic agent under the   authorization and supervision of a dentist in compliance with   Section 258.001(5); and                (7)  performs any other service, task, or procedure   prescribed by board rule.          SECTION 3.  (a) Not later than January 1, 2024, the State   Board of Dental Examiners shall:                (1)  prescribe by rule the requirements for a course to   train dental hygienists to administer a local anesthetic agent   consistent with Section 258.001, Occupations Code, as amended by   this Act;                (2)  develop a procedure for the approval of courses   described by Subdivision (1) of this subsection; and                (3)  adopt rules to administer Sections 258.001 and   262.002, Occupations Code, as amended by this Act, including rules   to establish the minimum standards for the administration of a   local anesthetic agent by a dental hygienist consistent with those   sections.          (b)  A rule adopted under Subsection (a)(1) of this section   must require that a course be offered in a classroom setting at an   educational institution accredited by the Commission on Dental   Accreditation of the American Dental Association.          SECTION 4.  This Act takes effect September 1, 2023.