GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2001
S	2
SENATE BILL 861*
Health Care Committee Substitute Adopted 6/11/01

Short Title:	License by Credentials/Dentistry.	()	
Sponsors:	     	
Referred to:	     	
April 4, 2001

A BILL TO BE ENTITLED
AN ACT TO ADDRESS SOME OF NORTH CAROLINA'S PUBLIC HEALTH PROBLEMS IN SHORTAGES OF LICENSED DENTAL PERSONNEL IN RURAL AND LOW-INCOME AREAS BY DEVELOPING PATHWAYS FOR NORTH CAROLINA STATE LICENSING OF DENTISTS AND DENTAL HYGIENISTS WHO ARE ALREADY LICENSED IN OTHER STATES OR JURISDICTIONS THROUGH PROVIDING FOR REVIEW OF THE PROFESSIONAL CREDENTIALS AND OTHER RECORDS OF ACTIVITIES BY APPLICANTS AS AN ALTERNATIVE TO REQUIRING APPLICANTS TO SATISFACTORILY COMPLETE A LICENSING BOARD CLINICAL EXAMINATION; BY ESTABLISHING A LIMITED VOLUNTEER DENTAL LICENSE; BY IMPROVING REGULATORY PROVISIONS FOR DENTAL FACULTY AND STUDENTS; BY ENACTING OTHER LICENSING CHANGE BY DIRECTING THE UNIVERSITY OF NORTH CAROLINA, IN COLLABORATION WITH THE STATE BOARD OF DENTAL EXAMINERS, TO STUDY AND DEVELOP PROCEDURES FOR INCREASING THE NUMBER OF DENTAL STUDENTS IN THE ENROLLING CLASS OF THE STATE SCHOOL OF DENTISTRY; AND BY DIRECTING THE BOARD OF GOVERNORS OF THE UNIVERSITY OF NORTH CAROLINA TO STUDY AND DEVELOP PROCEDURES FOR CREATING AN ADDITIONAL STATE DENTAL SCHOOL. 

The General Assembly of North Carolina enacts:
SECTION 1.  In order to emphasize the necessity of attracting and educating more private sector dental personnel for our State, and utilizing them to help address dental public health problems in rural and low‑income areas, Chapter 130A of the General Statutes is amended by adding a new section to read:
"§ 130A-367.  Dental providers for problem access areas.
The State's public health system cannot through its limited resources and personnel, provide and deliver all of the essential public health services that are needed by citizens who cannot independently obtain them. One of the missions of the system, as expressed in G.S. 130A-1.1(6), is promoting the availability and accessibility of quality health care services through the private sector. The State's dental public health program shall encourage the expansion of current educational and training programs for more dentists, dental hygienists, and dental assistants targeted to serve citizens' unmet needs, particularly in the rural and low-income areas that have traditionally had problems in accessing dental care. The program shall also promote and encourage the recruitment of in-State and out-of-state private sector dental personnel to work in these dental health professional shortage areas."
SECTION 2.  G.S. 90‑36 reads as rewritten:
"§ 90‑36.  Licensing practitioners of other states.

(a)	The Board shall have the authority to issue a license by credentials to an applicant who has been licensed to practice dentistry in any state or territory of the United States if the applicant produces satisfactory evidence to the Board that he or she has the required education, training, and qualifications, is in good standing with the licensing jurisdiction, has passed satisfactory examinations of proficiency in the knowledge and practice of dentistry as determined by the Board, and meets all other requirements set forth herein and in the rules of the Board. The Board is authorized to conduct examinations and interviews to thoroughly test the qualifications of the applicant and may require additional information which would affect the applicant's ability to render competent dental care. The Board may, in its discretion, refuse to issue a license by credentials to an applicant who the Board determines is unfit to practice dentistry.
(b)	The applicant for licensure by credentials shall be of good moral character and shall have graduated from and have a DDS or DMD degree from a program of dentistry in a school or college accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the Board.
(c)	The applicant shall:
(1)	Have been in active practice as defined in G.S. 90-29(b)(1) through (b)(9) for a minimum of five years immediately preceding the date of application;
(2)	Have not been the subject of final or pending disciplinary action in any state or territory in which he or she is or has ever been licensed to practice dentistry or in any state or territory in which he or she has held any other professional license;
(3)	Present evidence that he or she has no felony convictions whatsoever, or any other criminal convictions which would affect his or her ability to render competent dental care; and
(4)	Have not failed an examination conducted by the North Carolina State Board of Dental Examiners.
(d)	In addition to the above, the applicant for licensure by credentials shall submit an application, the form of which shall be determined by the Board, pay the fee required by G.S. 90-39, successfully complete tests in Jurisprudence and Sterilization and Infection Control, and meet the criteria or requirements established by the Board.
(e)	Once a license is issued to an individual on the basis of credential review, the holder of the license shall establish a practice location and actively practice dentistry as defined in G.S. 90-29(b)(1) through (b)(9) in North Carolina within one year from the date the license is issued. Once practice is initiated in North Carolina, the license by credential shall automatically become void if the licensee fails to limit his or her practice to North Carolina, or ceases to actively practice dentistry in North Carolina.
(f)	Notwithstanding the provisions of G.S. 150B-21.1(a), the Board is authorized to adopt temporary rules to implement this section."
SECTION 3.  Article 16 of Chapter 90 of the General Statutes is amended by adding a new section to read:
"§ 90-224.1. Licensure by credentials.
(a)	The Board shall have the authority to issue a license by credentials to an applicant who has been licensed to practice dental hygiene in any state or territory of the United States, if the applicant produces satisfactory evidence to the Board that he or she has the required education, training, and qualifications; is in good standing with the licensing jurisdiction; has passed satisfactory examinations of proficiency in the knowledge and practice of dental hygiene as determined by the Board; and meets all other requirements set forth herein and in the Rules of the Board. The Board may, in its discretion, refuse to issue a license by credentials to an applicant who the Board determines is unfit to practice dental hygiene.
(b)	The applicant for licensure shall be of good moral character, have graduated from an accredited high school or hold a high school equivalency certificate duly issued by a governmental agency or authorized unit, and have satisfactorily completed dental hygiene education and training, as required by a United States state or territory controlled program, which has been approved by the Board.
(c)	The applicant shall:
(1)	Have been in active dental practice as defined in G.S. 90-221(a) and supervised by a licensed dentist for a minimum of two years immediately preceding the date of application;
(2)	Have no history of disciplinary action or pending disciplinary action in the military, or in any state or territory in which he or she is or has ever been licensed;
(3)	Have no felony convictions whatsoever or other criminal convictions which would affect his or her ability to render competent dental hygiene care; and
(4)	Have not failed an examination conducted by the North Carolina State Board of Dental Examiners.
(d)	In addition to the above, the applicant for licensure by credentials shall submit an application, the form of which shall be determined by the Board, pay the fee required by G.S. 90-232, successfully complete tests in Jurisprudence and Sterilization and Infection Control, and meet other criteria or requirements established by the Board, which may include, but shall not be limited to, an examination or interview before the Board or its authorized agents.
(e)	This section shall not be construed to include licensure by reciprocity, which is prohibited.
(f)	Notwithstanding the provisions of G.S. 150B-21.1(a), the Board is authorized to adopt temporary rules to implement this section."
SECTION 4.  G.S. 90‑224 reads as rewritten:
"§ 90‑224.  Licensure by examination.
(a)	The applicant for licensure by examination shall:
(1)	Be of good moral character; 
(2)	Be a graduate of an accredited high school or hold a high school equivalency certificate duly issued by a governmental agency or unit authorized to issue the same; and 
(3)	Be either a graduate of a program of dental hygiene in a school or college approved by the  Board or have satisfactorily completed the dental hygiene education and training prescribed by the United States military service and have practiced dental hygiene in the military service for a minimum of five years and be in good standing with the military service as a dental hygienist.
(b)	The Board may establish in its rules and regulations:
(1)	The form of application;
(2)	The time and place of examination;
(3)	The type of examination;
(4)	The qualifications for passing the examination.
(c)	All examinations administered under this section shall be substantially equivalent in content."
SECTION 5.  In order to provide some relief from shortages of dentists to treat underserved low‑income populations in this State, Article 2 of Chapter 90 of the General Statutes is amended by adding a new section to read:
"§ 90-37.1. Limited volunteer dental license.
(a)	The North Carolina State Board of Dental Examiners may, under rules adopted by the Board in compliance with Chapter 150B of the General Statutes, issue to an applicant a special license to be entitled a 'Limited Volunteer Dental License' to practice dentistry only in nonprofit health care facilities serving low-income populations in the State. Holders of this limited volunteer license shall only be allowed to volunteer their professional services, without compensation, to help meet the dental health needs of these disadvantaged persons. The Board may issue a limited license to an applicant under this section who:
(1)	Has an out-of-state current or expired license, or an expired license in this State, or is authorized to treat veterans or personnel enlisted in the United States armed services; and
(2)	Has actively practiced dentistry within the past five years.
(b)	Such limited license may be issued to an applicant who produces satisfactory evidence to the Board that he or she has the required education, training, and qualifications; is in good standing with the licensing jurisdiction; has passed satisfactory examinations of proficiency in the knowledge and practice of dentistry as determined by the Board; and meets all other requirements set forth herein and in the rules of the Board. The Board is authorized to conduct examinations and interviews to thoroughly test the qualifications of the applicant and may require additional information that would affect the applicant's ability to render competent dental care. The Board may, in its discretion, refuse to issue a 'Limited Volunteer Dental License' to an applicant who the Board determines is unfit to practice dentistry.
(c)	The applicant shall be of good moral character and shall have graduated from and have a DDS or DMD degree from a program of dentistry in a school or college accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the Board.
(d)	The applicant shall:
(1)	Show that he or she has actively practiced dentistry as defined in G.S. 90-29(b)(1) through (b)(9) for a minimum of five years;
(2)	Show that he or she has not been the subject of final or pending disciplinary action in any state in which he or she has ever been licensed to practice dentistry or in any state in which he or she has held any other professional license;
(3)	Present evidence that he or she has no felony convictions whatsoever, or any other criminal convictions which would affect his or her ability to render competent care;
(4)	Present evidence that he or she has no pending Veterans Administration or military disciplinary actions or any history of such disciplinary action; and
(5)	Show that he or she has not failed an examination conducted by the North Carolina State Board of Dental Examiners.
(e)	In addition to the above, the applicant shall submit an application, the form of which shall be determined by the Board, pay the fee required under G.S. 90-39, and successfully complete tests in Jurisprudence and Sterilization and Infection Control. The Board is authorized to charge and collect fees for license application and annual renewal as required under G.S. 90-39; however, credentialing fees that might have been applicable under G.S. 90-39(13) are waived, as an incentive for practitioners to volunteer.
(f)	Successful applicants shall comply with the continuing dental education requirements adopted by the Board, including CPR training.
(g)	The holder of a limited license under this section who practices dentistry in a setting other than a nonprofit health care facility serving low-income populations shall be guilty of a Class 1 misdemeanor, with each day's violation constituting a separate offense, and upon conviction shall be punished in the discretion of the appropriate criminal court. Upon proof of such practice in unauthorized settings offered in the appropriate administrative law forum, the Board may suspend or revoke the limited license, in its discretion, after due notice. Furthermore, for violations of the dental practice act or its Rules as may be reasonably applicable to a limited license practice, the Board shall have the same authority to investigate and impose sanctions on limited license holders as it does for those holding an unlimited license. The Board shall maintain a nonexclusive list of nonprofit health care facilities serving the dental health needs of low-income populations in the State, and it shall consider approving other facilities on an individual basis."
SECTION 6.  G.S. 90‑39 reads as rewritten:
"§ 90‑39.  Fees.
In order to provide the means of carrying out and enforcing the provisions of this Article and the duties devolving upon the North Carolina State Board of Dental Examiners, it is authorized to charge and collect fees established by its rules and regulations not exceeding the following:
(1)	Each application for general dentistry examination	$500.00
(2)	Each general dentistry license renewal, which fee shall be annually fixed by the Board and not later than November 30 of each year it shall give written notice of the amount of the renewal fee to each dentist licensed to practice in this State by mailing such notice to the last address of record with the board of each such dentist	140.00
(2a)	Penalty for late renewal of any license or permit	50.00
(3)	Each provisional license	150.00
(4)	Each intern permit or renewal thereof	150.00
(5)	Each certificate of license to a resident dentist desiring to change to another state or territory	30.00
(6)	Repealed by Session Laws 1995, (Reg. Sess., 1996), c. 584, s. 1.
(7)	Each license to resume the practice issued to a dentist who has retired from and returned to this State	300.00
(8)	Each instructor's license or renewal thereof	140.00
(9)	With each renewal of a dentistry license, an annual fee to help fund special peer review organizations for impaired dentists	50.00
(10)	Each duplicate of any license, permit, or certificate issued by the Board	25.00
(11)	Each office inspection for general anesthesia and parenteral sedation permits	350.00
(12)	Each general anesthesia and parenteral sedation permit application or renewal of permit…………………………………………	50.00
(13)	Each application for license by credentials	2000.00
(14)	Each application for limited volunteer dental license	100.00
(15)	Each limited volunteer dental license annual renewal	25.00."
SECTION 7.  G.S. 90‑232 reads as rewritten:
"§ 90‑232.  Fees.
In order to provide the means of carrying out and enforcing the provisions of this Article and the duties devolving upon the North Carolina State Board of Dental Examiners, it is authorized to charge and collect fees established by its rules and regulations not exceeding the following:
(1)	Each applicant for examination	$125.00
(2)	Each renewal certificate, which fee shall be annually fixed by the Board and not later than November 30 of each year it 	shall give written notice of the amount of the renewal fee to 	each dental hygienist licensed to practice in this State by 	mailing such notice to the last address of record with the Board of each such dental hygienist	60.00
(3)	Each restoration of license	60.00
(4)	Each provisional license	60.00
(5)	Each certificate of license to a resident dental hygienist desiring to change to another state or territory	25.00
(6)	Annual fee to be paid upon license renewal to assist in funding programs for impaired dental hygienists	 40.00
(7)	Each license by credentials	1000.00.
In no event may the annual fee imposed on dental hygienists to fund the impaired dental hygienists program exceed the annual fee imposed on dentists to fund the impaired dentist program. All fees shall be payable in advance to the Board and shall be disposed of by the Board in the discharge of its duties under this Article."
SECTION 8.  G.S. 90‑29.5 reads as rewritten:
"§ 90‑29.5.  Instructor's license.

(a)	The Board may issue an instructor's license to a person who is not otherwise licensed to practice dentistry in the State, but whom the Board finds to meet the following conditions:
(1)	Is licensed to practice dentistry anywhere in the United States or in any country, territory, or other recognized jurisdiction; and
(2)	Has met or been approved under the credentialing standards of a dental school or an academic medical center with which the person is to be affiliated; such dental school or academic medical center shall be accredited by the American Dental Association's Commission on Accreditation or the Joint Commission on Accreditation of Health Care Organizations.
(b)	The holder of an instructor's license is authorized to teach and to practice dentistry:
(1)	In or on behalf of a dental school or college offering a doctoral degree in dentistry operated and conducted in this State and approved by the North Carolina State Board of Dental Examiners;
(2)	In connection with an academic medical center; and
(3)	At any teaching hospital adjacent to a dental school or an academic medical center.
(c)	Application for an instructor's license shall be made in accordance with the rules and regulations of the North Carolina State Board of Dental Examiners. On or after January 1, 2002, all dentists previously practicing under G.S. 90-29(c)(3) shall be granted an instructor's license upon application to the Board and payment of the required fee. The holder of an instructor's license shall be subject to the provisions of this Article."
SECTION 9.  G.S. 90‑29(c)(3) reads as rewritten:
"(3)	The teaching or practice of dentistry, in dental schools or colleges operated and conducted in this State and approved by the North Carolina State Board of Dental Examiners, by any person or persons licensed to practice dentistry anywhere in the United States or in any country, territory or other recognized jurisdiction until December 31, 2001. On or after January 1, 2002, all dentists previously practicing under G.S. 90-29(c)(3) shall be granted an instructor's license upon application to the Board and payment of the required fee."
SECTION 10.  G.S. 90‑41(f) reads as rewritten:
"(f)	As used in this section the term "licensee" includes licensees, provisional licensees and holders of intern permits, and the term "license" includes license, provisional license, instructor's license, and intern permit."
SECTION 11.  G.S. 90‑29.4(1) reads as rewritten:
"(1)	An intern permit shall be valid for no more than one year from the date of issue thereof; provided, however, that the Board may, in its discretion, renew such permit for not more than five additional one‑year periods; and, provided, further, that no person shall be granted an intern permit or intern permits embracing or covering an aggregate time span of more than  72 calendar months;".
SECTION 12. The University of North Carolina at Chapel Hill shall study and develop procedures for increasing the University of North Carolina School of Dentistry's entering class to 100 students.  The report shall include a timeline for increasing the number of students of the entering class of the University of North Carolina to 100 and for the costs of expansion.  In addition, the report shall include an analysis of the impact of this expansion on improving access to dental care in North Carolina.
Not later than May 1, 2002, the University shall report to the 2002 Regular Session of the 2001 General Assembly with a complete proposal and a timeline for increasing the number of students of the entering class of the University of North Carolina School of Dentistry to 100 students.
SECTION 13.  The Board of Governors of The University of North Carolina shall study the feasibility of establishing an additional State School of Dentistry.  The report shall include an analysis of the feasibility of establishing an additional State School of Dentistry, including costs, possible locations for the new facility, and a proposed timeline for implementation.  In addition, the report shall include an analysis of the impact of this expansion on improving access to dental care in North Carolina.
Not later than May 1, 2002, the Board of Governors shall report to the 2002 Regular Session of the 2001 General Assembly with a feasibility analysis of establishing a new State Dental School.
SECTION 14.  If any section of this act is declared to be unconstitutional, preempted, or otherwise invalid by the courts, except where a contrary intent is clearly indicated by the text of the section, it shall not affect the validity of the act as a whole or any part other than the section declared to be invalid, and any previous statutory law replaced or modified by the section declared invalid shall be reinstated as if the previous law had not been changed. If any part of a numbered section of this act is declared invalid, the whole section shall fail.
SECTION 15.  Sections 1 through 11 of this act become effective January 1, 2002. Sections 2 and 3 of this act shall expire and no longer have the force or effect of law at midnight on June 30, 2003. The remainder of this act is effective when it becomes law.