MISSISSIPPI LEGISLATURE

1999 Regular Session

To: Public Health and Welfare

By: Senator(s) Rayborn

AN ACT ENTITLED THE "MISSISSIPPI FREEDOM OF CHOICE DENTURES ACT"; TO REQUIRE AND ESTABLISH QUALIFICATIONS FOR THE LICENSURE OF DENTURISTS; TO ESTABLISH AND PROVIDE FOR THE MEMBERSHIP OF A MISSISSIPPI BOARD OF DENTURITRY; TO PROVIDE FOR EXAMINATIONS, FEES, LICENSING REQUIREMENTS, LICENSE SUSPENSION OR REVOCATION AND DISPOSITION OF RECEIPTS; TO REQUIRE DENTAL HEALTH INSURANCE POLICIES TO INCLUDE DENTURISTS' SERVICES; TO PROVIDE CRIMINAL PENALTIES FOR VIOLATIONS AND AN INJUNCTION PROCEDURE; TO AMEND SECTION 73-9-3, MISSISSIPPI CODE OF 1972, TO EXEMPT LICENSED DENTURISTS FROM THE DENTAL PRACTICE ACT; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. This act is enacted to promote competence and excellence in the providing of prosthetic dental appliances and services related thereto to the public at reasonable costs.

SECTION 2. This act shall be known as the "Mississippi Freedom of Choice of Dentures Act."

SECTION 3. As used in this act, unless the context requires otherwise:

(a) "Board" means the State Board of Denturitry.

(b) "Denture" means any removable full upper or lower prosthetic dental appliance to be worn in the human mouth.

(c) "Denturist" means a person licensed under this act to engage in the practice of denturitry.

(d) "Practice of denturitry" means:

(i) The making, fitting, constructing, altering, reproducing or repairing of a full upper or lower removable prosthetic denture, the repairing of a removable partial upper or lower prosthetic denture, the furnishing or supplying of such a denture directly to a person or advising the use of any such denture;

(ii) The taking or making, or the giving of advice, assistance or facilities respecting the taking or making of any impression, bite, cast or design preparatory to, or for the purpose of making, constructing, fitting, furnishing, supplying, altering, repairing or reproducing any such full upper or lower removable prosthetic denture;

(iii) The practice of denturitry within the context of this act requires that all work except cast frame work or work required to meet the needs of the homebound be performed on the licensee's premise.

SECTION 4. From and after July 1, 1999, a person must hold a license for the practice of denturitry in order to perform the following acts:

(a) Engage or offer to engage, in the practice of denturitry; or

(b) Use in connection with his/her name the word "denturist" or any other words, letters, abbreviations or insignia implying that such person is engaged in the practice of denturitry.

SECTION 5. The prohibitions of this act do not apply to:

(a) A person interning under the supervision of a denturist;

(b) The practice of dentistry or medicine by persons authorized to do so by this state;

(c) A student of denture technology in pursuit of clinical studies under an approved school program;

(d) A denture technician, as defined by board rule, performing services under the direction of a licensed denturist or licensed dentist when the service does not involve contact with the intended user.

SECTION 6. Prohibitions on activities of licensed denturists:

(a) He/she will not perform procedures which would alter any oral tissues or natural teeth.

(b) He/she will not insert or fit immediate dentures in the mouth of the intended wearer.

(c) He/she will not diagnose or treat any abnormalities of any human mouth.

(d) He/she will not prescribe any drugs or treatment for any oral or medical diseases.

(e) He/she will not construct or fit orthodontic appliances.

SECTION 7. (1) There is hereby created a Mississippi Board of Denturitry of the State of Mississippi, which shall consist of five (5) members. Three (3) members of the board shall be persons who have been nominated by the Association of Mississippi Denturists, Inc., who have had at least five (5) years continuous experience immediately prior to their nomination in the practice of denturitry. Two (2) other members of the board shall be lay persons nominated by the State Board of Health. At least two (2) nominees for each position must be nominated by the nominating body.

(2) The members of the board shall hold office for terms of three (3) years each; provided, of the initial board, the three (3) members to be appointed from nomination of the Association of Mississippi Denturists shall serve for terms of one (1) year, two (2) years, and three (3) years, respectively, as designated in their appointment, and of the initial board the two (2) lay members shall serve for terms of two (2) and three (3) years, respectively, as designated in their appointment. Thereafter members shall be appointed to the board for terms of three (3) years each, except that appointments to fill vacancies shall be for the unexpired term of such vacancies.

(3) Appointments to the board shall be made by the Governor from the nominees set forth in this section, subject to confirmation by the Senate, and each member of the board shall hold office for his term and until his successor is duly appointed by the Governor.

SECTION 8. (1) The board shall organize by the election of one (1) of its members as president, one (1) of its members as secretary, and one (1) of its members as treasurer; provided, that the offices of secretary and treasurer may be held by one (1) person. Officers of the board shall be elected for terms of one (1) year at the annual meeting of the board, but the same person may not hold the office of president for more than three (3) years in succession.

(2) The board shall meet at least annually to conduct its business and perform its duties, and shall meet at such other times as designated by the president or by request by two (2) or more members of the board.

(3) A majority of the board shall constitute a quorum for all purposes, and the majority vote of the members voting shall constitute the action of the board.

(4) The secretary of the board shall keep a complete record of all of its proceedings.

(5) Members of the board shall be compensated as provided in Section 25-3-41, Mississippi Code of 1972, for attending meetings of the board or for performing duties prescribed by this act and approved by the board.

(6) The board shall appoint a fair practice committee consisting of three (3) denturists selected from the membership of licensed denturists. This committee will meet as need arises and shall file a written report with the board on the decisions made.

SECTION 9. The board shall have the following powers and duties:

(a) To determine the qualifications of persons applying for licenses under this act;

(b) To prescribe, administer and determine examinations and a passing grade for licenses under this act;

(c) To collect fees and charges prescribed in this act to cover the operating expenses of the board as may become necessary from time to time;

(d) To issue licenses for the practice of denturitry under the conditions prescribed in this act;

(e) To revoke or suspend denturists' licenses in the manner prescribed by this act;

(f) To administer oaths and subpoena witnesses for the purpose of carrying out the activities authorized under this act;

(g) To make rules and regulations pursuant to the Administrative Procedures Act to carry out the intents and purposes of this act;

(h) To appoint committees and chairpersons and to delegate responsibilities to them as the need arises from time to time;

(i) To authorize, by written agreement, the State Department of Health, to act as agent in its interest.

SECTION 10. Upon application and payment of the appropriate fee, the board shall issue a license to practice denturitry to any applicant who meets one (1) of the following criteria:

(a) Applications filed prior to July 1, 1999:

Applicants must furnish two (2) signed affidavits by persons other than family members (or other evidence as may be prescribed by the board) that he/she has been employed for at least five (5) years prior to application in denture technology and is able to demonstrate competency in intra-oral procedures, and has successfully completed courses accredited by the board in head and neck anatomy and oral pathology; and has been a resident of the State of Mississippi for six (6) months prior to the filing of the application.

(b) Applications filed on or after July 1, 1999: Applicants must satisfactorily complete the examinations established by the board pursuant to this act; and have completed formal training of not less than two (2) years duration at an educational institution accredited by a national or regional accrediting agency recognized by the Board of Trustees of State Institutions of Higher Learning, the curriculum of which includes courses in oral pathology, physiology, head and oral anatomy, clinical microbiology, clinical jurisprudence, asepsis, and first aid for minor office emergencies; and have completed at least two (2) years internship under the supervision of a licensed denturist or have equivalent experience as established by board rule prior to the filing of the application.

SECTION 11. The board shall administer the examinations for licensing, subject to the following requirements:

(a) Examinations shall be of such character as to determine the qualifications, fitness and ability of the applicant to practice denturitry, with the form of the test to be written, oral, or a practical demonstration of skills, or such combination of the three (3) as the board may prescribe.

(b) The examination shall include coverage of the following subjects:

(i) Head and oral anatomy;

(ii) Oral pathology;

(iii) Physiology;

(iv) Clinical dental technology;

(v) Dental laboratory technology;

(vi) Microbiology;

(vii) Clinical jurisprudence;

(viii) Asepsis;

(ix) First aid for minor office emergencies.

SECTION 12. The board shall be entitled to charge and collect the following fees:

(a) An application fee (which shall include the cost of an examination when required) of not to exceed Three Hundred Dollars ($300.00);

(b) An initial license fee of not to exceed Three Hundred Dollars ($300.00);

(c) A renewal fee of not to exceed Six Hundred Dollars ($600.00).

SECTION 13. A denturist license shall be valid for a period of one (1) year, whereupon a renewal license will be issued upon payment of the renewal fee and the submission of proof of the completion of not less than twelve (12) hours continuing education accredited by the board during the one (1) year immediately preceding the date of application for renewal. A license issued effective as of a date other than July 1 will be valid until midnight June 30 next following the date it was issued. The license shall bear on its face the address where the licensee's denturist services will be performed.

SECTION 14. (1) The board shall have the power to refuse to issue a license, suspend or revoke a license, or place a licensed person on probation for a period specified by the board and subject to such conditions as the board shall impose, or reprimand or censure a licensee for any of the following causes:

(a) Conviction, finding of guilt, receipt of a withheld judgment or suspended sentence in this or any other state of a felony or of any other crime where such crime bears a demonstrable relationship to the practice of denturitry.

(b) Incompetence or gross negligence in the practice of denturitry.

(c) Fraud or misrepresentation in the practice of denturitry.

(d) Use of any narcotic or dangerous drug or intoxicating liquor to an extent that such use impairs the ability to conduct safely the practice of denturitry.

(e) The violation of any provision of this act or rules adopted thereunder.

(2) The board shall have the power to examine and inspect the place of business of any licensed denturist at a reasonable time and in a reasonable manner to assure compliance with this act.

(3) The board shall have the right to establish standards of conduct and practice, and the power to enforce such standards with monetary penalties and/or revocation or suspension of license.

SECTION 15. A denturist whose license has been revoked either by the Mississippi Board of Denturitry or the similar body of another state, shall not be eligible to apply for a license until one (1) year after the date of revocation.

SECTION 16. All monies received under the provisions of this act shall be deposited in the State Treasury to the credit of the operating fund of the board and all costs and expenses incurred by the board under the provisions of this act shall be a charge against and paid from said account. In no instance will the occupational license account be obligated to pay any claims which in aggregate with claims already paid exceed the income to the occupational license account which has been derived by the application of this act.

SECTION 17. Notwithstanding any provisions of any policy of insurance covering dental health, whenever such policy provides for reimbursement for any service which is within the lawful scope of practice of a denturist, the insured under such policy shall be entitled to reimbursement for such service, whether the service is performed by a licensed dentist or a licensed denturist. This section shall apply to any policy covering dental insurance which is issued after July 1, 1999. Policies which are in existence on July 1, 1999, shall be brought into compliance on the next anniversary date, renewal date or the expiration date of the applicable collective bargaining contract, if any, whichever date is latest.

SECTION 18. Violation of any provision of this act shall constitute a misdemeanor.

SECTION 19. (1) There shall be posted in a conspicuous area on any premises where the practice of denturitry is carried on, a notice with lettering of a size easily read by the average person and in substantially the following form:

(2) No person licensed under the provisions of this act shall directly or indirectly:

(a) Make any payment or gift to a person who has referred a patient;

(b) Receive or accept any rebate, payment or gift from any person to whom a patient is referred; or

(c) Engage in any form of fee-splitting or other form of sharing of remuneration, with respect to referrals.

(3) All denturist services will be unconditionally guaranteed for a period of not less than ninety (90) days.

SECTION 20. Any person who shall be aggrieved by any action of the board in denying, refusing to renew, suspending or revoking a denturist license may appeal therefrom to the district court in the county in which he/she is a resident. Such appeal shall be perfected by filing with the clerk of the circuit court, within thirty (30) days following the action of the board of which complaint is made, a notice of appeal setting forth briefly the action complained of and wherein the petitioner has been deprived of any legal rights. A copy of the notice of appeal shall be served upon the president or secretary of the board, and the court may sustain or reverse the action of the board or direct the board to take any further or other action with regard to the appeal.

SECTION 21. Whenever any person, corporation, partnership or association of any kind or nature violates any of the provisions of this act, the board, without regard to criminal prosecution, may maintain an action in the name of the State of Mississippi to enjoin said person, corporation, partnership or association from any further violations, such action to be brought either in the county in which said acts are claimed to have been or are being committed, in the county where the defendant resides, or in Hinds County. Upon the filing of a verified complaint in the chancery court, the court, if satisfied that the acts complained of have been or probably are being or may be committed, may issue an injunction pendente lite without bond, on request of the board, enjoining the defendant from the commission of any such act or acts constituting said violations. A copy of said complaint shall be served upon the defendant, and the proceedings shall thereafter be conducted as in any other similar civil action. If the commission of said act or acts be established, the court shall enter a decree perpetually enjoining said defendant from committing said act or acts. In case of violation of any injunction issued under the provisions of this section, the court, or the judge thereof at chambers, may summarily try and punish the offender for his contempt of court.

SECTION 22. Section 73-9-3, Mississippi Code of 1972, is amended as follows:

73-9-3. Any person shall be regarded as practicing dentistry within the meaning of this chapter who shall diagnose or profess to diagnose, or examine or contract for the treatment of, or treat or profess to treat, or hold himself out as treating any of the diseases or disorders or lesions of the oral cavity, teeth, gingivae, or maxillary and mandibular bones, or who shall extract teeth, repair or fill cavities in human teeth, correct malposition or irregularities of the teeth or jaws, practice surgery of the head or neck incident to the practice of oral surgery, or construct, repair or mend artificial teeth, crowns or bridges, or who shall administer anesthetics or use X-ray in connection with the practice of dentistry, or who shall engage in any other practice included in the curricula of dental schools accredited by the Council on Dental Education of the American Dental Association, provided that nothing herein shall be so construed as to prevent:

1. The practice of his profession by a regularly licensed and registered physician under the laws of this state unless he practices dentistry as a specialty; or

2. The performance of mechanical work upon inanimate objects by persons working in dental offices under their supervision; or

3. The operation of a dental laboratory and taking work by written work authorization from regularly licensed and registered dentists as provided for elsewhere in this chapter; or

4. Dentists from outside the state from giving educational clinics or demonstrations before a dental society, convention or association; or

5. Licensed dentists from outside the state from being called into Mississippi by licensed dentists of this state for consultative or operative purposes when such consultative or operative purposes have been authorized or approved by the Board of Dental Examiners for specified periods of time or as provided for by rules and regulations set forth by the board; or

6. Applicants for license to practice dentistry in this state from working during examination by and under the supervision and direction of the Board of Dental Examiners; or

7. The practice of dentistry or of dental hygiene by students under the supervision of instructors in any dental school, college, or dental department of any school, college, or university, or school of dental hygiene recognized by the board, but such activities shall not be carried on for profit; or

8. Dental interns or externs from being employed by licensed hospitals or other agencies recognized and approved by the board; or

9. A regularly licensed and registered dentist from the delegation of procedures to a regularly licensed and registered hygienist or other competent dental auxiliary personnel as he may direct while acting under the direct supervision and direction and full responsibility of the dentist except as follows: Those procedures which require the professional judgment and skill of a dentist such as diagnosis, treatment planning, surgical procedures involving hard or soft tissues, or any intra-oral procedure of an irreversible nature which could result in injury to the patient. Provided, however, the dentist shall delegate the removal of calcareous deposits only to a regularly licensed and registered dental hygienist as regulated by the State Board of Dental Examiners.

10. The practice of his profession by a regularly licensed denturist under Senate Bill No. ____, 1999 Regular Session.

All dentists and dental hygienists serving as instructors, professors or residents, as provided for in paragraphs 7. and 8. above, shall be required to be licensed by the Mississippi State Board of Dental Examiners.

SECTION 23. This act shall take effect and be in force from and after July 1, 1999.