1.1.................... moves to amend H.F. No. 535, as follows:
1.2Page 102, line 6, delete section 22 and insert:

1.3    "Sec. 22. [150A.105] ORAL HEALTH PRACTITIONER.
1.4    Subdivision 1. General. An oral health practitioner licensed under this chapter shall
1.5practice under the supervision of a Minnesota-licensed dentist and under the requirements
1.6of this chapter.
1.7    Subd. 2. Limited practice settings. An oral health practitioner licensed under
1.8this chapter is limited to primarily practicing in settings that serve low-income and
1.9underserved patients or in a dental health professional shortage area.
1.10    Subd. 3. Collaborative management agreement. (a) Prior to performing any of
1.11the services authorized under this chapter, an oral health practitioner must enter into
1.12a written collaborative management agreement with a Minnesota-licensed dentist. The
1.13agreement must include:
1.14(1) practice settings where services may be provided and the populations to be
1.16(2) any limitations on the services that may be provided by the oral health
1.17practitioner, including the level of supervision required by the collaborating dentist;
1.18(3) age and procedure specific practice protocols, including case selection criteria,
1.19assessment guidelines, and imaging frequency;
1.20(4) a procedure for creating and maintaining dental records for the patients that
1.21are treated by the oral health practitioner;
1.22(5) a plan to manage medical emergencies in each practice setting where the oral
1.23health practitioner provides care;
1.24(6) a quality assurance plan for monitoring care provided by the oral health
1.25practitioner, including patient care review, referral follow-up, and a quality assurance
1.26chart review;
2.1(7) protocols for administering and dispensing medications authorized under
2.2subdivision 5, including the specific conditions and circumstance under which these
2.3medications are to be dispensed and administered;
2.4(8) criteria relating to the provision of care to patients with specific medical
2.5conditions or complex medication histories, including requirements for consultation prior
2.6to the initiation of care;
2.7(9) supervision criteria of registered and nonregistered dental assistants; and
2.8(10) a plan for the provision of clinical resources and referrals in situations which
2.9are beyond the capabilities of the oral health practitioner.
2.10(b) A collaborating dentist must be licensed and practicing in Minnesota. The
2.11collaborating dentist shall accept responsibility for all services authorized and performed
2.12by the oral health practitioner pursuant to the management agreement. Any licensed
2.13dentist who permits an oral health practitioner to perform a dental service other than
2.14those authorized under this section or by the board, or any oral health practitioner who
2.15performs an unauthorized service, shall be deemed to be in violation of the provisions
2.16in sections 150A.01 to 150A.12.
2.17(c) Collaborative management agreements must be signed and maintained by the
2.18collaborating dentist and the oral health practitioner. Agreements must be reviewed,
2.19updated, and submitted to the board on an annual basis.
2.20    Subd. 4. Scope of practice. (a) A licensed oral health practitioner may perform
2.21dental services as authorized under this section within the parameters of the collaborative
2.22management agreement.
2.23(b) The services authorized to be performed by a licensed oral health practitioner
2.24include preventive, evaluative, and educational oral health services, as specified in
2.25paragraphs (c), (d), and (e), and within the parameters of the collaborative management
2.27(c) A licensed oral health practitioner may perform the following preventive,
2.28evaluative, and assessment services under general supervision, unless restricted or
2.29prohibited in the collaborative management agreement:
2.30(1) oral health instruction and disease prevention education, including nutritional
2.31counseling and dietary analysis;
2.32(2) assessment services, including an evaluation and assessment to identify oral
2.33disease and conditions;
2.34(3) preliminary charting of the oral cavity;
2.35(4) making radiographs;
2.36(5) mechanical polishing;
3.1(6) application of topical preventive or prophylactic agents, including fluoride
3.2varnishes and pit and fissure sealants;
3.3(7) pulp vitality testing; and
3.4(8) application of desensitizing medication or resin.
3.5(d) A licensed oral health practitioner may perform the following services under
3.6indirect supervision:
3.7(1) fabrication of athletic mouthguards;
3.8(2) emergency palliative treatment of dental pain;
3.9(3) space maintainer removal;
3.10(4) restorative services:
3.11(i) cavity preparation class I-IV;
3.12(ii) restoration of primary and permanent teeth class I-IV;
3.13(iii) placement of temporary crowns;
3.14(iv) placement of temporary restorations;
3.15(v) preparation and placement of preformed crowns; and
3.16(vi) pulpotomies on primary teeth;
3.17(5) indirect and direct pulp capping on primary and permanent teeth;
3.18(6) fabrication of soft-occlusal guards;
3.19(7) soft-tissue reline and conditioning;
3.20(8) atraumatic restorative technique;
3.21(9) surgical services:
3.22(i) extractions of primary teeth;
3.23(ii) suture removal; and
3.24(iii) dressing change;
3.25(10) tooth reimplantation and stabilization;
3.26(11) administration of local anesthetic; and
3.27(12) administration of nitrous oxide.
3.28(e) A licensed oral health practitioner may perform the following services under
3.29direct supervision:
3.30(1) placement of space maintainers; and
3.31(2) recementing of permanent crowns.
3.32(f) For purposes of this section, "general supervision," "indirect supervision,"
3.33and "direct supervision" have the meanings given in Minnesota Rules, part 3100.0100,
3.34subpart 21.
3.35    Subd. 5. Dispensing authority. (a) A licensed oral health practitioner may dispense
3.36and administer the following drugs within the parameters of the collaborative management
4.1agreement and within the scope of practice of the oral health practitioner: analgesics,
4.2anti-inflammatories, and antibiotics.
4.3(b) The authority to dispense and administer shall extend only to the categories
4.4of drugs identified in this subdivision, and may be further limited by the collaborative
4.5management agreement.
4.6(c) The authority to dispense includes the authority to dispense sample drugs within
4.7the categories identified in this subdivision if dispensing is permitted by the collaborative
4.8management agreement.
4.9(d) A licensed oral health practitioner is prohibited from dispensing or administering
4.10a narcotic drug as defined in section 152.01, subdivision 10.
4.11    Subd. 6. Application of other laws. A licensed oral health practitioner authorized
4.12to practice under this chapter is not in violation of section 150A.05 as it relates to the
4.13unauthorized practice of dentistry if the practice is authorized under this chapter and is
4.14within the parameters of the collaborative management agreement.
4.15    Subd. 7. Use of dental assistants. (a) A licensed oral health practitioner may
4.16supervise registered and unregistered dental assistants to the extent permitted in the
4.17collaborative management agreement and according to section 150A.10, subdivision 2.
4.18(b) Notwithstanding paragraph (a), a licensed oral health practitioner is limited to
4.19supervising no more than two registered dental assistants or nonregistered dental assistants
4.20at any one practice setting.
4.21    Subd. 8. Definitions. (a) For the purposes of this section, the following definitions
4.23(b) "Practice settings that serve the low-income and underserved" mean:
4.24(1) critical access dental provider settings as designated by the commissioner of
4.25human services under section 256B.76, subdivision 4, paragraph (c);
4.26(2) dental hygiene collaborative practice settings identified in section 150A.10,
4.27subdivision 1a, paragraph (e), and including medical facilities, assisted living facilities,
4.28federally qualified health centers, and organizations eligible to receive a community clinic
4.29grant under section 145.9268, subdivision 1;
4.30(3) military and veterans administration hospitals, clinics, and care settings;
4.31(4) a patient's residence or home when the patient is home-bound or receiving or
4.32eligible to receive home care services or home and community-based waivered services,
4.33regardless of the patient's income;
4.34(5) oral health educational institutions; or
4.35(6) any other clinic or practice setting, including mobile dental units, in which at least
4.3650 percent of the total patient base of the clinic or practice setting consists of patients who:
5.1(i) are enrolled in a Minnesota health care program;
5.2(ii) have a medical disability or chronic condition that creates a significant barrier to
5.3receiving dental care; or
5.4(iii) do not have dental health coverage, either through a public health care program
5.5or private insurance, and have an annual gross family income equal to or less than 200
5.6percent of the federal poverty guidelines.
5.7(c) "Dental health professional shortage area" means an area that meets the criteria
5.8established by the secretary of the United States Department of Health and Human
5.9Services and is designated as such under United States Code, title 42, section 254e."
5.10Renumber the sections in sequence and correct the internal references
5.11Amend the title accordingly